The National Asthma Council Australia (NAC) has issued a caution regarding the inclusion of asthma medications that were today listed on the Pharmaceutical Benefits Scheme (PBS) with the option of a 60-day prescription.
From the 1st of September, over 70 Asthma inhalers may be available for asthma patients to receive multiple inhalers at each dispensing.
Associate Professor Debbie Rigby, Clinical Executive Lead at the National Asthma Council Australia, said that while the NAC supports cheaper medicines for consumers, this needed to be balanced with the need for vigilance around medication expiry and wastage.
“60-day dispensing could work very well for patients who have good asthma control and are stable, however we know that in Australia this is not the case for many.
“Having a 12-month supply of medication removes the need to go back to the GP for a script at six months which means the patient misses out on a key opportunity for their GP to assess their asthma management.
“The NAC’s Australian Asthma Handbook also includes recommendations for stepping down treatment in adults and adolescents if asthma is well controlled for 2-3 months. If the patient doesn’t visit their GP within 12 months they could remain on the same higher strength too long,” said Associate Professor Rigby.
She added that wastage is also a big potential issue that needs to be discussed with patients.
“60-day dispensing could be good news for Australians living with asthma if it helps to reduce the cost of their medication, which in turn may improve adherence to preventer therapy and improved asthma health outcomes.
“However, if the patient needs their inhaler strength changed and they already have the extra supply of the previous medication, it could lead to unnecessary wastage and cost to the health system.
“In addition, some inhaler devices are packaged in a foil or plastic pouch and once these inhalers are opened, they must be used within a specified timeframe to avoid reduced stability and efficacy.
“This includes most multi-dose reservoir dry powder inhalers (eg. Turbuhaler, Genuair, Spiromax, Easyhaler) as they are particularly susceptible to high humidity and some powder formulations that are moisture sensitive. Adsorption of moisture can significantly increase powder cohesiveness, leading to decreased dispersal and generation of fine particles during inhalation, which may lead to reduced efficacy and increased adverse effects due to increased oropharyngeal deposition,” she said.
“This is particularly relevant to Ellipta devices which have a one month in-use shelf life, potentially leading to sub-optimal efficacy or wastage.
“In addition, some inhalers must be stored in a refrigerator prior to dispensing, however they can be stored at room temperature after dispensing and in-use for a maximum of two months. If a patient opens both inhaler devices at the same time, they still need to be used within the two months and there is a risk that poor adherence may extend the in-use period.
“The NAC encourages all health professionals to discuss these important issues with their patients and ensure the inclusion of asthma medication to the 60-day dispensing list has a positive impact on their asthma control and doesn’t place them at higher risk of serious asthma flare-ups and hospitalisations,” said Associate Professor Rigby.
