3 March 2020

Source:  BioPharmaDispatch Author: Paul Cross

The Pharmaceutical Benefits Advisory Committee will consider loosening the prescribing authority for PBS-listed hepatitis C medicines but the real focus seems to be on securing a price reduction.

The Department of Health notified companies with the reimbursed direct-acting antivirals in writing last week that the issue would be considered at the PBAC's March meeting.

The Committee will consider the potential loosening of the authority level from 'authority-required' to 'streamlined'.

The letters arrived just days after a stakeholder roundtable was convened to discuss the utilisation of the cures, including the decline in uptake.

BioPharmaDispatch understands that during the roundtable stakeholders did not focus on the authority as a barrier to utilisation and officials did not state the PBAC would consider the issue at its upcoming meeting.

It is unclear the extent to which changing the authority level would impact the uptake of the therapies. The federal government would benefit from an uptake in utilisation because of the existing deed of agreement.

Under the agreement, which expires in early 2021, the per-patient cost falls if uptake and spending on the therapies rise above specified caps - more people are cured at a lower per-patient cost. Lower utilisation means higher per-patient cost. However, while changing the authority level may not lead to an increase in uptake with the potential lower per-patient cost, the federal government would immediately 'lock-in' a saving from any related price reduction.

The utilisation of the therapies surged when they were first reimbursed in early 2016. It subsequently fell with monthly new patient initiations sitting at or below 1,000 new patients for most of the past two years.

The new Department of Health secretary Professor Brendan Murphy, who was previously the Chief Medical Officer, told BioPharmaDispatch in 2018 that achieving the goal of eliminating hepatitis C by the target date of 2030 requires 1,500 to 2,000 new patient initiations every month.

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Updated: 3 March 2020