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More people living with severe asthma will be able to access life-changing, injectable asthma drugs called biologics therapies following an announcement under the Pharmaceutical Benefits Scheme (PBS) to expand eligibility and relax medical red tape around wait times.
Approximately three to five per cent of Australians with asthma are affected by diagnosed severe asthma, a form of asthma which remains uncontrolled despite maximal asthma preventer therapy. This means daily activities like work, study or running a busy household could be unachievable due to health complications and multiple hospital admissions.
The Australian Government estimates an additional 1,000 patients each year can now afford to use these medicines, saving people up to $23,000 per year, listed on the PBS last December.
“It gives people who are very unwell a realistic hope of a normal healthy life, that’s the kind of difference these therapies can make,” says CEO of Asthma Australia, Michele Goldman.
For eligible people, they may now be able to trial one of three new, advanced drugs called monoclonal antibody therapies (biologics therapies) under the PBS.
Ms Goldman said the widening of eligibility criteria and dropping a six month wait time between trials meant more people could access these expensive medicine’s worth between $450 and more than $1,600 per month, at the price of $40 per prescription under the PBS.
“A dime compared with full costs for this incredible medication. Although, costs may still be unaffordable to patients who will be paying for a significant amount of asthma treatments and could be experiencing economic impacts from having poor health such as employment barriers. In this case, the potential benefits could mean a renewed ability to work full time or study,” Ms Goldman says.
“Patients who self-fund outside the parameters of the PBS subsidy to access these therapies can be up for very high costs depending what therapy they are prescribed,” she added.
Biologics therapies are considered ground-breaking as they target pathways in the immune system that cause the problematic airway inflammation seen in asthma. They are indicated for use in severe eosinophilic asthma and severe allergic asthma.
Professor Peter Gibson, respiratory physician and Asthma Australia Professional Advisory Council Member says, “biologics therapies make a big difference, for example, a 50 per cent reduction in the rate of severe attacks. We expect to see reduced presentations for asthma attacks in severe asthma patients.”
Gold Coast mother of two and severe asthmatic, Danielle Welsh knows first-hand the benefits of biologics therapy as she says her “…life has changed dramatically” and before accessing it “she was barely alive.”
“I can’t begin to accurately describe how much this has changed my life.”
“I was on up to 18 medications. I was spending between a week to two weeks in hospital over the course of a month. Then a lot of time at home recovering. I was in the ICU two to three times a year and have been intubated three times. I was unable to work or study and was almost exclusively recovering at home or in hospital.”
“I was so unwell before. I couldn’t live my life; I couldn’t enjoy life. I was completely dependent on my husband. I couldn’t work and had to give up university for a time. Following biologics, my life is completely different. I work full time as a senior science teacher and I love my job. I have had two beautiful children. I am now able to be an active and fun wife and mother. I have only had one hospital admission in the last four years. My life is completely different and utterly changed.”
Previously, accessing biologics therapy wasn’t so simple for Ms Welsh who is relieved access is now easier.
“I have been on this therapy for over five years now and the initial process was quite difficult. I needed specific evidence of my medications (dosage, timing etc), my asthma control, my general medical history, my GP and hospital records of admissions, notes from my specialists and much more.”
“The ongoing process is quite easy for me now though. I see my specialist every six months to ensure that it’s is still working well for me and they renew the prescription through the appropriate channels and send it out to me a few weeks later.”
“This process is 100 per cent worth it as my asthma control is exceptional compared to before. My life has changed dramatically, and I am now able to actually live my life,” Ms Welsh said.
Ms Goldman says, “with this change, more biologics will be used, encouraging investment in the development of more ground-breaking treatments.”
To be eligible for monoclonal antibody therapy under the PBS, a patient must be under the care of the same specialist for at least a six-month period, or less if they have received a diagnosis by a multidisciplinary asthma clinic team.
Monoclonal antibody therapies are typically administered in a hospital setting, but in some situations the initiation and continued administration of the treatment may be conducted in primary care, provided specific conditions are met.
“Some GPs will be administering or supervising therapy with severe asthma patients on a monthly or even fortnightly basis,” Ms Goldman says.
Ms Goldman adds that even though this medicine is now more accessible, the basics of asthma management are still just as important.
“Patients who appear to have uncontrollable asthma may also be failing to follow their prescribed management or have a poor inhaler technique. It’s really important GPs cover the basics first to ensure people aren’t falling through the cracks before considering biologics therapies,” she says.
For Danielle, there’s no turning back as her life has been significantly improved.
For people with diagnosed severe asthma, they can ask their GP about accessing biologics therapies. They will need to be referred to a specialist to be considered for biologics.