Funding cuts raise doubts over biologics prescribing program


By Rosanne Barrett and Michael Woodhead

12 Apr 2022

Doubts have been raised about the future of the Value in Prescribing bDMARDs Program for dermatologists as a result of the government-funded NPS MedicineWise being stripped of its funding for its Quality Use of Medicines (QUM) programs in the 2022 federal Budget.

Last week it was revealed the Australian government would shift $5.7 million in funding over seven years to “redesign the existing Quality Use of Diagnostics, Therapeutics and Pathology Fund to support the appropriate use of medicines”.

The Value in Prescribing program was set up by NPS MedicineWise in 2018 with the aim of saving $50 million in bDMARD costs by encouraging specialists such as dermatologists and rheumatologists to prescribe the cheapest DMARDs.

As part of the program, dermatologists are being invited to have an educational visit from a NPS MedicineWise consultant “to discuss the latest evidence around biologics, highlighting both gaps and uncertainties in evidence as well as best practice and the latest guidelines.”

According to NPS MedicineWise documents, the Value in Prescribing program’s aims are to to encourage specialist prescribers to “comply with national policies and guidelines in the use of medicines other than bDMARDs where it is clinically appropriate.”

“This includes ensuring prescribers understand PBS restrictions and that subsidised bDMARDs are only prescribed for PBS approved services,” the agreement with the Department of Health states.

The program also seeks to ensure “the clinically appropriate use of the lowest priced bDMARDs by providing tools to alert specialist prescribers and pharmacists to the different price points across equally effective but different bDMARDs.”

However, buried in the detail of the 2022 Australian Government Budget papers — without specifically mentioning NPS MedicineWise — are changes representing the loss of guaranteed funding for the organisation’s core role.

“A number of QUM functions currently delivered by NPS MedicineWise will be transferred to ACSQHC,” a spokesman for NPS confirmed to the limbic.

“NPS MedicineWise will no longer receive any uncontested funding from the Department of Health to support the Quality Use of Medicines.”

The NPS has served as “steward” of the medicines program since 1998.

“The defunding of an independent agency that has the singular focus on QUM risks a dilution of focus on QUM,” the NPS MedicineWise spokesman said.

“We are disappointed and concerned with what this means for Australia at a time when quality and safe use of medicines is listed as a National Health Priority.”

“The NPS MedicineWise model of a national implementation body at arm’s length from government remains as important today as it was 24 years ago. Our track record demonstrates the success of this approach to achieving national policy objectives, improved prescribing and health outcomes, consumers as partners in their healthcare, and PBS and MBS sustainability.”

NPS MedicineWise said it had demonstrated $1.1 billion in direct savings for the Pharmaceutical Benefits Scheme and Medicare Benefits Schedule over the 25 years of its operations.

However its long-serving CEO Dr Lynn Weekes stood down in 2018 after a $40 million funding cut was announced in the 2017/18 Budget by the Coalition government.

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