If patients want to qualify for PBS subsidies, GPs will need to get out their script pads from 1 May.
New contraceptive, endometriosis and fertility medications will be subsidised through the PBS, the federal government announced yesterday.
Speaking to The Medical Republic, vice president of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists Dr Nisha Khot said that patients will need new scripts to qualify for the reimbursements.
“These changes will allow doctors to prescribe the most effective medications for their patients without financial barriers limiting access,” she said.
“It’s important for all doctors, including GPs and specialists, to note that from 1 May 2025, patients will need a new prescription to qualify for PBS reimbursements.
“Doctors may need to inform their patients about this requirement to ensure access to reimbursement.”
From 1 May, endometriosis medication relugolix with estradiol and norethisterone will be subsidised for patients who cannot get sufficient pain relief from other treatments.
The government estimates 8500 patients, that would otherwise be paying around $2700, will benefit each year.
Speaking to press yesterday, federal health minister Mark Butler responded to criticism that the government had waited 12 months to act on the PBS recommendation to list the endometriosis medication, which was made on 13 March 2024.
“I want to clarify that although the Advisory Committee did issue a recommendation in March last year, the company exercised its right to take the matter back to the Advisory Committee,” he said.
“They weren’t happy with the scope of the recommendation, and so a final recommendation was only listed by the Pharmaceutical Benefits Advisory Committee in January this year.”
Fertility medication follitropin alfa with lutropin alfa is currently subsided for patients with low levels of reproductive hormones – known as severe follicle-stimulating hormone and luteinising hormone deficiency – in late-stage IVF cycles.
It is currently used by an estimated 6000 patients.
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From 1 April, the medication will be subsidised for use earlier in patients’ IVF journeys.
The maximum number of doses per script will also be increased from two to four.
Four doses currently cost over $3500.
Fertility Society of Australia and New Zealand president Dr Petra Wale said Australia was facing a “fertility crisis”.
“The total fertility rate has fallen to 1.5 babies per women – the lowest ever recorded and well below the replacement rate of 2.1,” she said.
“The cost of assisted reproduction remains a major barrier for many families, particularly amid the ongoing cost-of-living crisis.”
Around 20,000 babies a year are born though IVF.
National medical director at Adora Fertility Dr Paul Atkinson said the announcement was a “big win” for patients with fertility issues.
“Our patients will now be able to access [the drug] from the get-go, rather than having to first go through the anguish of multiple cycles,” he said.
“More cycles mean more time, and for women up against their biological clock this adds another challenge to the IVF process.”
Drospirenone, a progestogen-only-pill, currently costs around $320 a year.
From 1 May, the contraceptive, which is an alternative for those who can’t take estrogen, will also be subsided on the PBS.
This is expected to benefit around 100,000 people.
Sexual health physician Dr Terri Foran said that that contraception was a fundamental reproductive right.
“Progestogen-only pills are especially suitable for older women, women at increased risk of blood clots, those who suffer migraine attacks, breast-feeding mothers, those who smoke, are overweight, or have high blood pressure,” she said.
“With greater education about contraceptive options and the risks and benefits associated with each, we are seeing increasing use of both progestogen-only birth control methods and the longer-acting methods in this country.”
When asked about the cost of the new announcements, Mr Butler said the numbers would be presented in the budget papers in due course.
“Some of those are subject to commercial negotiations, but this will be covered by the usual PBS budget arrangements.”
Dr Knot renewed calls for a gendered review of the MBS, the PBS and the private health funds.
