Diabetes is currently one of the most significant challenges facing global health. In Australia, around 280 people develop diabetes each day, with type 2 diabetes accounting for approximately 85% of cases. The rising incidence of this chronic condition has resulted in diabetes becoming a significant cause of blindness, kidney failure, heart attacks, stroke, and lower limb amputations in this country.

From 1st April 2018, a number of diabetes medications have been added to the Pharmaceutical Benefits Scheme (PBS) or had their existing entries expanded as summarised in Table 1.

Table 1. Additions and changes to PBS-subsidised medications for type 2 diabetes

Medication

Restrictions*

Insulin Glargine
(Toujeo®)

Unrestricted

Dapagliflozin
(Forxiga®)

Streamlined authority – not subsidised for monotherapy or in combination with a thiazolidinedione or glucagon-like peptide-1

Dapagliflozin + Metformin
(Xigduo® XR)

Streamlined authority – not subsidised for initiation of dual oral combination therapy, or in combination with a thiazolidinedione or glucagon-like peptide-1

Dapagliflozin + Sitagliptin
(Qtern®)

Streamlined authority – treatment must be in combination with metformin

Empagliflozin
(Jardiance®)

Streamlined authority – not subsidised for monotherapy or in combination with a thiazolidinedione or glucagon-like peptide-1

Empagliflozin + Metformin
(Jardiamet®)

Streamlined authority – not subsidised for initial therapy, monotherapy, or in combination with a thiazolidinedione or glucagon-like peptide-1

Empagliflozin + Linagliptin
(Glyxambi®)

Streamlined authority – treatment must be in combination with metformin

Linagliptin + Metformin
(Trajentamet®)

Streamlined authority – not subsidised for initiation of dual oral combination therapy, or in combination with a thiazolidinedione or glucagon-like peptide-1

Vildagliptin
(Galvus®)

Streamlined authority – treatment must be in combination with metformin and/or a sulfonylurea, or insulin

Vildagliptin + Metformin
(Galvumet®)

Streamlined authority – patients inadequately controlled on optimal doses of dual oral therapy

*See PBS website for details.

Complications are the major cause of morbidity and mortality in patients with type 2 diabetes and are associated with significant increases in the mean cost of treatment per patient. Optimisation of pharmacotherapy, together with lifestyle modifications, can significantly reduce the incidence of microvascular and macrovascular complications in this patient group.

References:

  1. Department of Health. The Pharmaceutical Benefits Scheme. Canberra, Australia.
  2. Diabetes Australia. Diabetes in Australia. Turner, Australia.

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