PBAC backs alternative to Zoladex in breast cancer

The Pharmaceutical Benefits Advisory Committee (PBAC) has recommended that triptorelin, already listed on the Pharmaceutical Benefits Scheme (PBS) for prostate cancer, be funded for the treatment of breast cancer, endometriosis and gender dysphoria.

The recommendation follows an urgent PBAC meeting in July convened after AstraZeneca announced it would withdraw Zoladex (goserelin) 3.6mg from the Australian market. The subcutaneous implant is a cornerstone monthly therapy used in pre- and perimenopausal women with hormone receptor–positive (HR+) breast cancer.

The decision raised significant concerns that more than 7,500 women with breast cancer could be left without an alternative treatment.

Vicki Durston, Director of Policy and Advocacy at Breast Cancer Network Australia, described the PBAC recommendation as “a significant step forward, and an important example of what can happen when consumer voices, clinical expertise and government come together”.

Rachelle Panitz, CEO of So Brave, told Health Industry Hub, “It’s great to see movement in the alternative medication space. We are hoping this gets onto the PBS quickly.”

The PBAC recommendation aligns with earlier views from clinical experts, including Professor Fran Boyle AM, Professor of Medical Oncology at the University of Sydney and Mater Hospital in North Sydney, who referenced the SOFT and TEXT breast cancer trials in which triptorelin was used as ovarian suppression therapy.

For Durston, the development also highlights broader faultlines in how Australia manages access to essential medicines.

“When an essential medicine is withdrawn, continuity of treatment cannot be left to women and their clinicians to navigate after the fact. We need earlier coordination, clear communication and replacement pathways built into the system from the outset,” she said. “We are not at the end of this process. PBS listing, reimbursement and supply still need to be secured before 1 November 2026.”

Marilla Druitt, Victorian State Chair of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, said it remained unclear whether triptorelin would deliver exactly the same outcomes as Zoladex, but welcomed the prospect of an alternative, particularly for patients with endometriosis and pelvic pain.

“I’m glad we’ve got an alternative,” she said. “That’s fantastic, and it remains to be seen whether or not it will be as good, but pain is so complex, pain is a really hard thing to study because it’s got so many contributors.”

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