23 October 2023

PBS authorities: it’s go time for online and streamline

Biologics PBS Plaque psoriasis Rheumatoid Arthritis

The PBS has announced changes for biologics and targeted synthetic DMARDs used in severe active rheumatoid arthritis, starting next week.

This means that most RA patients on these meds will now be able to walk out of the clinic room with their script, slashing the administrative burden on rheumatologists.

From Wednesday 1 November, authority requirements will change for the following DMARDs:

  • adalimumab
  • abatacept
  • baricitinib
  • certolizumab
  • etanercept
  • golimumab
  • infliximab
  • tocilizumab
  • tofacitinib.

Originator brands

For initial and first continuing therapy of originator or reference drugs for rheumatoid arthritis, it’s still Authority Required (Written).

For subsequent continuing therapy of originator or reference drugs, listings change from Authority Required (Written) to Authority Required (Streamlined), taking a massive burden off prescribers.

Biosimilars

For biosimilars, the initial prescription will change from Authority Required (Written) to Authority Required (telephone/immediate online assessment).

The real-time assessment of authority requests is available through Services Australia’s Online PBS Authorities (OPA) system, via Health Professional Online Services (HPOS). Once their eligibility is approved, patients can leave the consultation with the prescription for their medicine.

The first continuing therapy for biosimilars will change to Authority Required (Streamlined), and it remains Streamlined for subsequent continuing therapy.

In making the prescription of biosimilars less burdensome, the government hopes to encourage greater use of them, making medicines more affordable, allowing greater access and potentially reducing the risk of medicine shortages.

Full details are available on the PBS website.

The initiative is part of the Department of Health and Aged Care’s digital transformation of Authority Required (Written) PBS listings and follows changes to authority listings for giant cell arteritis and juvenile idiopathic arthritis prescriptions in July this year.

Also announced were changes to the prescription of etanercept for children and adolescents with severe chronic plaque psoriasis. Initial prescriptions will change from Authority Required (Written) to Authority Required (telephone/immediate online assessment). Continuing therapy will change to Authority Required (Streamlined).

Dr John Frew, a staff specialist dermatologist at Liverpool Hospital in Sydney, said the “exciting” changes would allow clinicians to provide treatment for children with chronic plaque psoriasis in a timelier manner.

“This removes a lot of the paperwork that many clinicians have to deal with when prescribing these medications, allowing them to make a simple phone call or use a streamlined authority code to give paediatric patients access to this safe and effective treatment without needing to wait days – or possibly weeks – to access the medication,” he said.

Chronic plaque psoriasis is more common in adults than in children but can cause embarrassment in the younger population due to the highly visual nature of the condition.

“It has a significant impact on quality of life and functioning, [as well as] the ability to concentrate at school,” Dr Frew explained.

Changes to authority listings for prescriptions for ankylosing spondylitis are also in the pipeline.

Additional reporting by Lincoln Tracy