February 2, 2018

Recommendations released through review of COPD Medicines

A report outlining the findings and recommendation from a Post-market Review of COPD Medicines has been released following its endorsement by the Federal Health Minister: http://www.pbs.gov.au/info/reviews/post-market-review-chronic-obstructive-pulmonary-disease.

Due to the considerable recent changes in COPD management, including the PBS listing of a number of new medicines, the review looked at the utilisation, safety, efficacy and cost-effectiveness of PBS-listed COPD medicines, and addressed QUM concerns associated with the apparent use of multiple products. Among the key findings and recommendations:

  • The key clinical guidelines of relevance to Australian practice are the Lung Foundation Australia COPD-X Guidelines and the GOLD Strategy Report.
  • The current PBS prescribing rules and levels for dual bronchodilator combination (LAMA/LABA) and inhaled corticosteroid/bronchodilator combination (ICS/LABA) medicines do not align with the recommended medicine treatment pathway in the guidelines.
  • Removing the requirement to stabilise patients on a LAMA and LABA separately, prior to initiation of LAMA/LABA FDC – this will help to reduce device confusion and possible delays in treatments.
  • There is a high rate of initiation to inhaled corticosteroids/bronchodilator (ICS/LABA) combinations medicines, which is inconsistent with clinical guidelines.

View the two page summary of findings here: http://www.pbs.gov.au/reviews/copd-report/Plain-language-summary-COPD.PDF

Lung Foundation Australia CEO, Heather Allan, said they had welcomed the review outcomes and the opportunity to be involved through the Reference Group, which was established to provide independent expert clinical advice and consumer input.

“We are strongly in favour of identifying any variation that exists across the management of COPD and formulating solutions to limit this,” Ms Allan said.

“Lung Foundation Australia is very pleased to see a holistic perspective in the report and the inclusion of crucial aspects, such as pulmonary rehabilitation, spirometry and education,” she said.

Professor Christine McDonald, Respiratory Specialist and Chair of the Lung Foundation Australia National COPD Program, also supported the outcomes from the review.

“Implementing the recommendations outlined in this report will help to reduce the confusion felt by many clinicians and patients around the variety of available therapies and devices. This is an important step in reducing potential inadvertent medicine duplication and possible delays in treatment.

For more information about the COPD-X Guidelines and other evidence-based clinical management tools, please visit http://lungfoundation.com.au/health-professionals/copd/

About COPD

  • COPD or Chronic Obstructive Pulmonary Disease is a long term disease of the lungs which causes shortness of breath and a persistent cough4.
  • COPD is a lung disease that affects 14% (or one in seven) Australians aged 40 or over.1 This figure increases to 29% in Australians aged 75 or over. 1
  • 5% of Australians 40 years old or over have COPD that has progressed to where symptoms may already be present and affecting daily life. Half of these people will not know they have COPD. 4
  • COPD is the second leading cause of avoidable hospital admissions.5
  • In 2013, COPD was the fifth leading cause of death in Australia. In that year 6,462 people died from COPD (4.4% of all deaths).6
  • Despite falling death rates, COPD is still a leading cause of death and disease burden after heart disease, stroke and cancer.7