23 August 2023

Shingrix to be funded from 1 November

PBS pharmaceutical

PBAC recommends eligibility expansion for varicella virus recombinant vaccine to all aged 65 and up, but avacopan for GPA/MPA misses out in the July 2023 outcomes.


The Pharmaceutical Benefits Advisory Committee has recommended the varicella virus recombinant vaccine (Shingrix, GSK) be listed on the NIP for an increased range of patients.

The July PBAC outcomes, released Friday 18 August, recommended Shingrix be a designated vaccine for the purposes of the National Health Act 1953, for the prevention of herpes zoster among people aged 65 years and older.

PBAC previously recommended the vaccine be available to those aged 70, with no catch-up program for older people who’d missed out. The latest recommendation to include non-Indigenous people aged 65-69 and 71 and older means there would be no upper age limit to the catch-up program.

This is in addition to those already recommended by PBAC for eligibility for the free vaccine, including Aboriginal and Torres Strait Islander individuals aged 50 and older, and people with immunocompromise aged 18 and older.

PBAC also noted that Shingrix will be available on the National Immunisation Program as of 1 November 2023 for people with immunocompromise aged 18 and older, non-Indigenous people aged 70 and Aboriginal and Torres Strait Islander individuals aged 50 and older, as recommended in the March 2023 PBAC meeting.

Currently, ATAGI recommends patients 18 and older with immunocompromise receive the Shingrix vaccine over Zostavax to prevent herpes zoster. ATAGI has yet to confirm which patients will meet criteria for funded Shingrix under this recommendation.

Noting the high cost of the program, PBAC has left the door open for a reassessment of its cost-effectiveness if a booster dose is needed or the long-term efficacy is less than predicted.

And in positive news for patients with atypical haemolytic uraemic syndrome, PBAC recommended the Authority-required listing of ravulizumab (Ultomiris, Alexion Pharmaceuticals) under the Section 100 Highly Specialised Drugs Program.

PBAC also recommended extending the PBS listing of ravulizumab for paroxysmal nocturnal haemoglobinuria to paediatric patients under the Section 100 Highly Specialised Drugs Program.

Meanwhile, another adalimumab biosimilar, Ardalicip (Cipla Australia) has been recommended under the same conditions as the reference biologic for conditions including severe active juvenile idiopathic arthritis, severe active rheumatoid arthritis, severe psoriatic arthritis, ankylosing spondylitis, severe chronic plaque psoriasis and moderate to severe hidradenitis suppurativa.

In other outcomes, avacopan (Tavneos, Vifor Pharma) was not recommended for treatment of severe active granulomatosis with polyangiitis (GPA) and severe active microscopic polyangiitis (MPA) in combination with rituximab or cyclophosphamide/azathioprine. While acknowledging the clinical need for steroid-sparing drugs in these conditions, PBAC considered the economic model was unreliable due to the uncertainties underpinning clinical data.

Lilly’s request to have its ixekizumab (Taltz) pack size increased from one to two units for nr-AxSpA was also not recommended, as was Novartis’ request for an authority required listing for secukinumab (Cosentyx) for hidradenitis suppurativa.