PBAC advises 6 crucial changes to managing COPD


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High rates of inhaled steroid prescribing for COPD patients, low levels of lung function testing, and poor patient inhaler technique and adherence have prompted the PBAC to recommend a raft of changes to PBS requirements to improve the management of COPD in Australia.

“There is a concern that ICS use in COPD populations correlates to a 40–70% increase in the risk of pneumonia” and that up to 83% of patients don’t use their inhalers correctly, the PBAC noted, despite clinical guidelines to the contrary.

Respiratory physician and Lung Foundation Australia National Council member Associate Professor Lucy Morgan says: “There has been an explosion of new versions of COPD medications over the last few years. Prescribers have more choice and this can contribute to confusion.”

GPs will see the following changes following the recent release of the PBAC’s final report and outcomes of its post-market review of COPD medicines, which is expected to be signed off by Federal Minster for Health Greg Hunt.

1. PBS restriction eased for bronchodilator combinations 

GPs will no longer need to stabilise patients on both a long-acting beta2-agonist (LABA) and a long-acting muscarinic antagonist (LAMA) monotherapy separately before they can commence a LAMA/LABA fixed-dose combination. 

In keeping with the COPD-X guidelines, the PBS will require previous use of only one monotherapy before stepping up to a combination.

2. PBS restriction tightened for ICS/LABA combinations