PBS restrictions lead to outdated and unsafe care


Prescribing restrictions for anti-epileptic medication expose flaws within the evaluate means of the Pharmaceutical Advantages Scheme (PBS), a College of Queensland researcher proposes.

UQ neurologist Professor Christian Gericke stated the PBS wanted to implement an efficient evaluate means of its personal restrictions that might enable Australian medical doctors to prescribe in accordance with American and European medical tips that facilitated protected and up-to-date medical follow.

“The PBS urgently must replace anti-epileptic drug restrictions that put sufferers and prescribers in danger,” Professor Gericke stated.

“When a brand new remedy is first listed on the PBS, prescribing restrictions are put in place to guard the taxpayer from unreasonably excessive prices.

“The present system for itemizing medication is properly organised and gives an excellent steadiness between taxpayer and affected person pursuits.

“However there’s at the moment no ample and efficient mechanism to evaluate PBS restrictions as soon as they’re in place.

“In the long run, this fosters outdated prescribing follow and suboptimal care.”

Professor Gericke stated the issue was not restricted to anti-epileptic medication however they have been a obvious instance of it.

In 2018, the Therapeutic Items Administration Advisory Committee on Medicines suggested medical doctors to keep away from prescribing the widespread anti-epileptic drug valproate to pregnant ladies, as a result of threat of start defects and diminished intelligence in kids uncovered to valproate throughout being pregnant.

“Nevertheless the TGA suggestions can’t be carried out in day by day prescribing follow in Australia until the PBS lifts its restrictions on different anti-epileptic medication,” Professor Gericke stated.

“In follow, most epileptologists and plenty of physicians and basic practitioners ignore the PBS restrictions and observe the worldwide prescribing tips to be able to present protected care for his or her sufferers.

“These medical practitioners are liable to authorized and monetary sanctions.

“It is not honest on medical doctors, and it is not honest on our sufferers.

“Medical doctors shouldn’t be pressured to decide on between protected affected person care and complying with outdated authorities regulation.”

Professor Gericke referred to as on the PBS to urgently replace its restrictions on using anti-epileptic medication and to create a daily evaluate mechanism of its personal prescribing restrictions for all medicines on the PBS.

“This can enable Australian medical doctors to prescribe in step with worldwide finest follow with out imposing a monetary burden on sufferers or contravening PBS rules,” he stated.


An opinion paper co-authored by Professor Gericke and Epilepsy Society of Australia president Professor Terence O’Brien from Monash College is printed as we speak within the Medical Journal of Australia.

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