News & Trends - Pharmaceuticals
Caution issued over patient safety as 60-day prescription expands to asthma medicines
Pharma News: From September 1, coinciding with the start of National Asthma Week, Australians will have access to over 70 asthma inhalers under the 60-day prescription scheme, alongside approximately 300 other medicines. This marks the third group to transition to the extended prescription format.
Associate Professor Debbie Rigby, Clinical Executive Lead at the National Asthma Council (NAC), cautioned against potential pitfalls such as medication expiry and wastage.
“Having a 12-month supply of medication removes the need to go back to the GP for a script at 6 months which means the patient misses out on a key opportunity for their GP to assess their asthma management,” she noted.
“The NAC’s Australian Asthma Handbook also includes recommendations for stepping down treatment in adults and adolescents if asthma is well controlled for 2 to 3 months. If the patient doesn’t visit their GP within 12 months they could remain on the same higher strength too long.”
Asthma Australia’s Kerry Goldsworth shared a personal perspective, saying “When my sons were young, this 60-day prescribing would have made the world of difference to me, because I was buying three preventers at a time for myself, for my two sons, that would have equated to about $90 a month saving just for us, just on our asthma medications.”
Goldsworth added, “There are families going without medications out there, choosing whether to pay their electricity bill, whether to buy food. If I take my preventer one day late, I could be in in the ED in hospital. This is how dire it can be with asthma. This initiative will mean a lot to a lot of people.”
Associate Professor Rigby added that wastage is also a big potential issue that needs to be discussed with patients.
“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,” she cautioned.
She specifically mentioned challenges with multi-dose reservoir dry powder inhalers, noting their susceptibility to moisture which can affect efficacy and lead to increased adverse effects due to increased oropharyngeal deposition.
There is also the potential for patients to open more than one inhaler device at the same time, thus exposing the inhaler to the same in-use shelf life. This is particularly relevant to GSK’s Ellipta device which have a one month in-use shelf life.
The latest additions to the 60-day prescriptions cover a broad spectrum of conditions including acne, anxiety, constipation, depression, gastro-oesophageal reflux disease, glaucoma, dry eyes, obstructive pulmonary disease, and Parkinson’s disease.
While all preventer inhalers for asthma are covered under the scheme, salbutamol, terbutaline and ipratropium inhalers and salbutamol nebules are not included.
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