Australia's Pharmaceutical Benefits Scheme (PBS) advisory committee has recommended that the federal government fund the drug triptorelin for the treatment of breast cancer, endometriosis, and gender dysphoria in children. The committee's urgent meeting in July was prompted by AstraZeneca's announcement to remove Zoladex from the market, which could leave more than 7,500 women with breast cancer without an alternative treatment.
Triptorelin, which has been PBS-listed for prostate cancer since 2006, would become unrestricted and funded for all uses if the recommendation is adopted. Historically, the government has implemented the committee's recommendations. Both triptorelin and Zoladex block the release of oestrogen and testosterone, which are crucial for treating some cancers and for fertility preservation, and are considered essential medicines by the World Health Organization. They can also treat endometriosis and block puberty.
Vicki Durston, director of policy and advocacy at Breast Cancer Network Australia, called the decision "a significant step forward," noting that access to the drug could be life-saving for some patients. Marilla Druitt, Victorian state chair for the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, welcomed the alternative but noted it is unclear if triptorelin will be exactly as effective as Zoladex for endometriosis and pelvic pain patients, suggesting further research is needed.
If the federal government accepts the recommendation, gender-affirming care would be funded by the federal taxpayer through the PBS for the first time. This would remove a financial barrier for transgender children in Queensland and the Northern Territory, where bans on prescribing drugs for gender-affirming care in public hospitals have been in place. The medical director of Gender Health Australia, Stuart Aitken, expressed "absolute joy" among his patients, stating it removes a significant barrier to evidence-based care.
A PBS listing would reduce the cost of private prescribing from approximately $3,000 a year to about $300, or $25 a week, according to Brisbane GP Fiona Bisshop. This reduction in cost could mitigate the impact of state-level bans. The Queensland government's own review of treatments, which did not recommend continuing the ban, found that it created risks including inequity due to socioeconomic status. However, the health minister, Tim Nicholls, extended the ban until at least 2031, pending findings from a UK trial.