The Australian Pharmaceutical Benefits Scheme (PBS) has expanded its listings to include new medications for juvenile arthritis, a rare liver disease, and multiple sclerosis, making these treatments available at subsidized prices. Concurrently, the maximum general co-payment for PBS-listed medications has been reduced to $25.
New Medication Listings
Adalimumab (Humira®)
Adalimumab, marketed as Humira®, has been added to the PBS for the treatment of juvenile idiopathic arthritis and other pediatric immune-mediated inflammatory diseases (IMIDs). These include Crohn’s disease, ulcerative colitis, and chronic plaque psoriasis. The medication functions by moderating the immune system and reducing inflammation. Estimates indicate that between 18,500 and 30,100 Australians aged 0-24 are affected by arthritis. Without the PBS subsidy, a single script for Humira® would cost approximately $650.
Odevixibat (Bylvay®)
Odevixibat, known as Bylvay®, has received its first listing on the PBS for progressive familial intrahepatic cholestasis (PFIC). PFIC is a group of rare genetic liver diseases that primarily affect children, leading to bile acid accumulation in the liver, which can cause liver damage and potentially necessitate a liver transplant. Bylvay® works to reduce bile acid levels in the gut. Globally, PFIC is estimated to affect between one per 50,000 and one per 100,000 live births. The unsubsidized cost for a script of Bylvay® could exceed $200,000.
Ublituximab (Briumvi®)
Ublituximab (Briumvi®) has also been added to the PBS for the first time, specifically for relapsing-remitting multiple sclerosis (RRMS). RRMS is an autoimmune disease that impacts the central nervous system. Briumvi® targets B-cells to reduce inflammation, decrease relapse frequency, and slow disease progression in multiple sclerosis. In 2024, over 14,000 patients accessed comparable treatments through the PBS. The unsubsidized cost for a Briumvi® script is approximately $15,000. This listing represents the second consecutive month that a new treatment for RRMS has been added to the PBS, following the December approval of an ocrelizumab (Ocrevus) injection for adult patients.
PBS Co-payment Adjustments
As of January 1, the maximum general co-payment for PBS-listed medications has been reduced from $31.60 to $25. For concession card holders, the co-payment remains $7.70, a rate expected to continue until 2030.
The Pharmaceutical Benefits Scheme in Context
The Pharmaceutical Benefits Scheme is a component of the Australian Government’s National Medicines Policy. Established in 1948, the scheme currently lists over 900 medicines, encompassing more than 5,000 different brands. The Department of Health, Disability and Ageing is responsible for managing the PBS, with administration handled by Services Australia. Health Minister Mark Butler confirmed these recent expansions and adjustments to the scheme.