Menopause hormone treatments to keep the PBS list



Although general practitioners have welcomed the news, some fear that a subsequent increase in prices will represent further gaps in access to care.

The flexibility offered by hormonal transdermal patches helps improve access to treatment for women.

The Pharmaceutical Benefits Scheme (PBS) and the Department of Health have reached an agreement with pharmaceutical company Sandoz to keep menopause treatments on PBS with an updated price to “support a continued and sustainable supply of products”.

The deal follows extensive lobbying from the Australasian Menopause Society (AMS), RANZCOG and the Endocrine Society of Australia, including a letter to Health Minister Greg Hunt in May opposing the removal offered products from October 1.

Hormonal transdermal patches containing estradiol or estradiol with norethisterone are sold under the names Estradot, Estalis Continuous and Estalis Sequi, and offer important treatment options for postmenopausal women.

AMS President-elect Dr Karen Magraith welcomed the news.

“The combined estrogen-progestin patch is the only combined transdermal product available in Australia, and it is vital that this option remains available on PBS,” she said. gp news.

“It is a particularly practical and accessible option for women because it only requires a single prescription and the use of a single product. The patch offers an option for transdermal estrogen which is well accepted by patients in a range of doses.

“Additionally, transdermal estrogen does not confer the risk of venous thromboembolism that oral estrogen can, so it is an appropriate option for many women.”

Dr Magraith said the flexibility offered by the product is an important benefit and can help improve access to treatment.

“Access to treatment is clearly an important issue for many patients, and the importance of the continued availability of a range of treatment options depending on the patient’s individual circumstances is increasingly recognized.” she declared.

‘[For example,] estrogen patches are also used by some transgender patients and continued access is important to them. ‘

GP and women’s health advocate, said associate professor Magdalena Simonis gp news that continued and sustainable access to treatment is “a good thing and very welcome”.

“It has been a very difficult time for women trying to get an MHRT substitute. [menopausal hormone replacement therapy] during COVID-19 and this year, due to supply shortages,’ she said.

“Switching to other products has not always been suitable for women and the options have in some situations resulted in higher overall expenses for women as they have had to stop and try something different multiple times. to get closer to the desired results. “

However, while PBS access to these MHRT products will continue, supplier Sandoz has declared that the price will increase from October 1 to reflect the “increasing cost of manufacturing these drugs.”

Both doctors are concerned about the impact of rising prices on women, especially those on low incomes, and say it further highlights inequalities in access to healthcare in Australia.

“The price increase will be prohibitive for low-income women who do not receive a health card, which, taking into account the gender pay gap has increased by 14% in the last fiscal year, is another blow, “said Dr Simonis.

“It is unfortunate that overall 10% of postmenopausal women require MHRT, and the overall cost for PBS if there were no price increase would be relatively small.”

Dr Magraith had previously warned of the implications of a price increase, which she said is now “unfortunate” and will be noticed by non-concessional patients.

“Hormonal therapy, when used appropriately, is not an ‘optional’ or ‘lifestyle’ treatment as is sometimes assumed, and it is important that patients can afford the treatment that is prescribed for them, “she said.

“It is especially essential for women with early menopause or premature ovarian failure to have appropriate treatment.

“For some women, the optimal treatment may be a transdermal estrogen patch with micronized progesterone capsules, which are not listed in PBS. Taken together, the treatment can be prohibitive for some women.

“AMS will follow the matter with interest.”

It is not yet clear what the proposed price increase will be, but Sandoz’s previous request to the Pharmaceutical Benefits Advisory Committee ranged from $ 7.35 to $ 24 per script on PBS, with private prices as high as $ 30 to $ 24 per script. $ 40 per month.

Dr Simonis continues to raise the issue of gender inequalities as well as financial barriers when it comes to accessing healthcare, citing an example of drug use.

“The issue of gender and sex in older women: Viagra is only prescribed for men and only prescribed for erectile dysfunction,” she said. “Viagra was put on PBS in May 2021.

‘[For women,] Urogenital syndrome symptoms include uncomfortable or painful intercourse and can also affect the bladder leading to cystitis-like symptoms or even recurrent urinary tract infections in older women.

“These conditions affect a large proportion of perimenopausal and menopausal women and for many the only relief is MHRT.

“The decision to fully fund Viagra through PBS while increasing out-of-pocket costs for women who need MHRT is discriminatory.

“The message this sends to the community is that the sexual needs of men are considered more important than the sexual needs of older women.”

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