Key facts
- An advisory committee recommended the Pharmaceutical Benefits Scheme (PBS) fund triptorelin for breast cancer, endometriosis, and gender dysphoria.
- Triptorelin is already PBS listed for prostate cancer.
- The recommendation follows AstraZeneca's decision to remove Zoladex from the market, impacting over 7,500 women with breast cancer.
- Funding triptorelin would make gender-affirming care accessible via the PBS for the first time, reducing costs significantly.
- The expanded coverage is expected to be implemented in November.
The Pharmaceutical Benefits Scheme’s (PBS) advisory committee has recommended the federal government fund the drug triptorelin for a wider range of conditions, including breast cancer, endometriosis, and gender dysphoria. This urgent recommendation follows AstraZeneca's decision to withdraw Zoladex from the market, potentially leaving over 7,500 women with breast cancer without a crucial treatment.
Triptorelin, already listed on the PBS since 2006 for prostate cancer, functions by blocking the release of estrogen and testosterone. These hormones are sometimes necessary for treating certain cancers and for fertility preservation. The World Health Organization considers drugs that block estrogen and testosterone as essential medicines. Beyond cancer treatment, triptorelin can be used for endometriosis and to manage precocious puberty or to block puberty in gender-affirming care.
Breast Cancer Network Australia has welcomed the recommendation, with policy director Vicki Durston stating that access to the drug could be life-saving for some patients. Some individuals had already opted for ovary removal due to supply uncertainties. The Royal Australian and New Zealand College of Obstetricians and Gynaecologists acknowledged the positive implications for endometriosis and pelvic pain patients, though noted further research would be needed to confirm triptorelin's efficacy compared to Zoladex.
If adopted by the government, this expanded PBS listing would mark the first time gender-affirming care is funded by the federal taxpayer. This move is expected to eliminate a significant financial barrier for transgender children in Queensland and the Northern Territory, where similar bans on public hospital prescribing had been implemented. Medical Director of Gender Health Australia, Stuart Aitken, expressed that the decision brings "absolute joy" to patients by removing a major obstacle to evidence-based care.
Fiona Bisshop, a GP from Stonewall Medical Center, highlighted that a PBS listing would drastically reduce the annual cost of private triptorelin prescriptions from approximately $3,000 to $300. She noted that cost had been a primary barrier in Queensland. A state government review had previously warned that the ban created legal, ethical, and regulatory risks, including inequity based on socioeconomic status or location. The review also found evidence suggesting puberty blockers can reduce gender-related distress. Despite this, the Queensland Health Minister extended the ban until at least 2031, pending UK trial results. Triptorelin, like most drugs used in gender-affirming care, is prescribed off-label and is not approved by the Therapeutic Goods Administration for this specific use. The expanded PBS coverage is anticipated to take effect in November.