First oral contraceptive PBS listing in three decades

Yaz® and Yasmin® (drosperinone with ethinylestradiol) are now on the PBS.

This will help “level the playing field” for women, says sexual health physician Dr Terri Foran, Conjoint Senior Lecturer, School of Women’s and Children’s Health, UNSW.

“Women and their physiology are quite different. The way we all react to various dosages and preparations is quite unique and individual. The nice thing about having a wider range of choices is that you stand a better chance of finding a preparation that suits that woman.”

“And from a medical perspective, there’s nothing more tragic than knowing a certain pill would be the best choice and having someone tell me that they simply cannot afford to pay for it,” Dr Foran says.

Older pills will still be the first choice in most cases because we have more safety data about them, Dr Foran says. “But my feeling is there’s probably 10% or so of women who really find those pills do not suit them.”

“It’s when those people come back and say, ‘This isn’t working or I’m having this side effect’, and there needs to be some intelligent prescribing of a preparation that best suits that particular person’s needs, that having the option of an alternative preparation that is PBS-listed and therefore not constrained by issues around the ability to pay for it — I think that’s going to make a difference.”

GP and medical educator Dr Sara Whitburn, Medical Director of Sexual Health Victoria and chair of the RACGP’s Sexual Health Specific Interest Group, says it offers more cost-effective options and increases the range of available progestogens.

“And we know that having different progestogens can be useful for people to decrease their side effects. And that Yaz and Yasmin have had studies done into how they might help with acne and fluid retention, but also with premenstrual syndrome. So it means that we’re able to make more decisions based on what might be a clinically appropriate progestogen,” she says.

The listing of drosperinone with ethinylestradiol (Yaz® and Yasmin®) is expected to benefit around 50,000 women each year, who would otherwise pay around $380 per year and will now pay $126.40 a year, or $30.80 a year if they have a concession card.

Body identical MHTs now on the PBS

Estradiol (Estrogel®), progesterone (Prometrium®) and estradiol and progesterone (Estrogel® Pro) are also now PBS-listed.

Professor Rod Baber AM, Clinical Professor of Obstetrics & Gynaecology at The University of Sydney and Past President of the International Menopause Society says this means best practice body identical hormones will now be affordable.

“For over 20 years it has been clear that the use of government-regulated body identical menopausal hormone therapy is, in most cases, the method of choice and offers an excellent benefit to risk profile,” he says.

“With the addition of these new menopausal hormone options, all Australian women will now be able to receive best practice body identical MHT in an affordable manner,” he says.

“It is important to note that whilst use of body identical menopausal hormone therapy is best practise, the choice of oral or transdermal route of delivery should still be based on an individual risk benefit assessment and personal preferences,” Professor Baber adds.

Around 150,000 women are expected to benefit each year. They will now pay a maximum of $31.60 each month, saving up to $290 a year, or $7.70 per month with a concession card, saving up to $577 a year.

Remind patients that they will need a new script to get the discounted price

The Department of Health and Aged Care has reported confusion regarding the new PBS schedule already, and have asked prescribers to remind patients that any prescriptions dated before 1 March will not be eligible for the PBS subsidised price. Patients will need to get a new prescription in order to access the PBS price.