Improving Community Access to Palliative Care Medicines

Many people who want to receive palliative care at home are unable to afford the medicines they need. Many patients gain these through public hospitals, either as inpatients or outpatients. To address this, a key area of the National Palliative Care Program is to improve access to affordable medicines, through the Pharmaceutical Benefits Scheme (PBS). The Palliative Care Medicines Working Group, which has representatives from clinical disciplines, government, consumers and the pharmaceutical industry has been working to enable essential palliative medications to be subsidised.

The Australian Government has demonstrated its commitment to providing affordable access for palliative care medicines by including palliative care medicines recommended for subsidy by the Pharmaceutical Benefits Advisory Committee (PBAC) in a new section in the PBS Schedule.

It is important to note that this new section of the Schedule is intended to complement and be used together with the general listings section, where many drugs used in palliative care can be found.

How to use the Palliative Care Section of the PBS

For the purpose of prescribing under the Palliative Care Section of the PBS, a patient receiving palliative care is defined as: A patient with an active, progressive, far-advanced disease for whom the prognosis is limited and the focus of care is the quality of life. This means that any patient with a life-limiting disease can access these medicines, regardless of the type of disease.

All palliative care listings are “Authority Required”. All prescribers can request an initial authority to provide a maximum of 4 months therapy for palliative care patients. Where a subsequent authority is requested for continuing treatment, the provision of repeats is subject to confirmation by the prescriber that a palliative care physician or palliative care service has been consulted regarding the care of the patient.

In order to support this initiative, it is important that the authority system and not the general benefits system is used when a drug is available in both lists, but restricted to non-palliative indications in the general benefits list.

Authority approvals can be obtained through phoning 1800 888333 (General benefits) and 1800 552580 (Repatriation Benefits).

What now?

The Palliative Care Clinical Studies Collaborative (PaCCSC) has been established to gather the evidence required to support further PBS listings.

PaCCSC is a group of palliative care units across Australia, which will gain the scientific evidence needed to gain TGA approval of many of the medicines currently only available freely in public hospitals to treat symptoms of palliative care.

These studies may support the registration of a number of medicines used in palliative care on the Australian Register of Therapeutic Goods and subsequently support their listing on the PBS.

For further information go to www.health.gov.au and for updates to the PBS schedule, go to www.pbs.gov.au.