PBAC recommendation to reshape prescribing in heart failure

Pharma News: Aligned with the government’s Scope of Practice Review, the Pharmaceutical Benefits Advisory Committee (PBAC) has made a practice-changing recommendation to grants nurse practitioners the authority to commence SGLT-2 inhibitor therapy for chronic heart failure within a shared-care framework alongside clinicians.

The success of the Boehringer Ingelheim-led submission will allow 2,250 nurse practitioners to prescribe Jardiance (empagliflozin 10mg) as an adjunct to standard of care therapy for adults with symptomatic heart failure regardless of ejection fraction, as well as the 60-day dispensing PBS listing for heart failure with reduced ejection fraction (HFrEF).

Federal Minister for Health, Mark Butler MP, emphasised the government’s commitment to the Unleashing the Potential of our Health Workforce – Scope of Practice Review.

“When I left the health portfolio last time [11 years ago], there were around 2,000 nurse practitioners around Australia, and I was pretty disappointed to discover when I came back to the portfolio a decade later, there were still only 2,000 nurse practitioners in the whole of Australia. About 500-600 of them are not even working as nurse practitioners because there aren’t the jobs available. We are determined to change that,” Minister Butler expressed.

Dirk Otto, General Manager, Boehringer Ingelheim Australia and New Zealand, said “This is a practice-changing recommendation. It will be a win for heart failure patients, nurse practitioners and the broader health system. It is consistent with guideline-recommended multidisciplinary heart failure management programs in which nurse practitioners are a key player.”

The Australian College of Nurse Practitioners (ACNP) CEO, Leanne Boase, welcomed the PBAC recommendation, saying “Nurse practitioners are experts in complex disease management and ideally placed to initiate and oversee heart failure treatment.

“ACNP is actively supporting the removal of financial restrictions on medicines, allowing optimisation of nurse practitioner scope of practice within prescribing legislation, and equitable access to medicines. We hope to see these medicines become even more accessible for patients in the future.”

Boehringer Ingelheim’s submission highlighted “the opportunity to harness the expertise of nurse practitioners to enhance heath system efficiencies and improve treatment access for eligible heart failure patients, particularly in remote and regional communities”.

Mr Otto explained, “This change will allow nurse practitioners to prescribe Jardiance as initial or continuing therapy to help ensure quality and safety in medication management, benefiting heart failure patients and the Australian healthcare system.”

The government has committed to removing the legislated requirement for collaborative arrangements for nurse practitioners and endorsed midwives which will allow them to prescribe without a doctor looking over their shoulder. The Scope of Practice Review final report is due to the government by October.

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