Fingolimod, Ofatumumab, Siponimod
Amendment to PBS listings to allow nurse practitioners to initiate and continue treatment of fingolimod, ofatumumab, and siponimod in consultation with a specialist physician for the treatment of multiple sclerosis.
Decision on record
- Meeting Nov 2024 Recommended Multiple sclerosis
Access path
- Nov 2024Recommended
- PBS listing · Authority Required
From the public summary
5.1 The PBAC recommended the amendment to the PBS listings of fingolimod, ofatumumab and siponimod to allow nurse practitioners (NPs) to initiate and continue treatment in consultation with a specialist physician for the treatment of multiple sclerosis (MS).PSD · Nov 2024
5.2 The PBAC noted the submission did not propose any changes to the diagnostic pathway or criteria for MS and that the patient’s diagnosis would remain with the neurologist. The PBAC also noted the submission stated patients stable on MS 5PSD · Nov 2024
4.2 The PBAC noted and welcomed the input from six health care professionals and two organisations via the Consumer Comments facility on the PBS website. The comments from health care professionals stated that many patients with MS live in rural, regional and remote settings and these patients may experience difficulties in securing an appointment with a GP or neurologist.PSD · Nov 2024
4.3 The Multiple Sclerosis Nurses Australasia organisation provided support for NP prescribing of MS treatments, noting this would improve the quality, accessibility and continuity of care for patients living with MS, allowing for more efficient healthcare delivery and reducing delays to treatment.PSD · Nov 2024
Cost-effectiveness
This is a Category 4 submission requesting a prescriber change amendment with no new clinical or economic evaluation; no ICER calculated.
Decision context
PopulationPatients with multiple sclerosis (relapsing-remitting MS for fingolimod and ofatumumab; secondary progressive MS for siponimod) suitable for treatment by nurse practitioners in consultation with a specialist physician.
Submission history
| Decided | Outcome | Comparator | ICER | Evidence |
|---|---|---|---|---|
| Nov 2024 | Recommended | — | — | Cost-minimisation |
Consumer voice
Six healthcare professionals and two organisations (Multiple Sclerosis Nurses Australasia and MS Australia) supported nurse practitioner prescribing of MS treatments, citing improved accessibility, reduced treatment delays, better continuity of care, and enhanced patient outcomes, particularly for rural and regional patients.
allowing NPs to prescribe medicines for MS in consultation with a specialist physician would reduce delays in commencing treatment, reduce impact on general practitioners and reduce cost to patients for seeking medical consultations. Consumer comments · PSD
Similar precedents
Regulatory · TGA
Label narrower than PBS population — PBAC restricted to patients suitable for nurse practitioner initiation/continuation in consultation with specialist, versus TGA's broader label allowing any prescriber.