Connected Care Blog | Dr Irwin Lim | Arthritis Care

Have your say! TREXJECT pre-filled syringe listing submission

Written by Dr Irwin Lim | 12-Jan-2017 19:37:21

1st post for the year. And this is a plea for your help. Directed to those of you using Methotrexate, especially if you are using Methotrexate by injections.

Many people use Methotrexate. For some, the injectable form is preferable to the oral due to better absorption and potentially lower side effects by bypassing the oral route. There is trial data suggesting the injectable route can be more effective in rheumatoid arthritis.

I had previously written that I use injectable (parenteral) Methotrexate less than I should for a variety of reasons (read post here). One of the big issues is the inconvenience of not having a pre-packed pre-filled syringe available in Australia.

This changed in 2016 when our Therapeutic Goods Administration registered Trexject, a range of pre-filled syringes. While the powers-that-be registered this for use in Australia, they did not agree to actually reimburse it on our pharmaceutical benefits scheme meaning that it is very expensive to use and this has meant that it has been out of reach for most.

The TGA listing of Trexject also led to the unintended consequence that compounding pharmacists who were helping patients by filling syringes with Methotrexate at the correct dose and setting up the syringes for ready use, then needed to stop producing pre-filled syringes for my patients due to the availability of this TGA-approved formulation.

This has led to more inconvenience for my patients with many now attending their GP practices for GPs and/or nurses to draw up their Methotrexate from vials to then deliver the injection. This leads to wasted time and increased costs for Medicare. 

And it leads to reluctance to use injectable Methotrexate despite the noted benefits due to the increased complexity.

The pharmaceutical company behind Trexject, Link Healthcare, has prepared another submission to try and get this formulation reimbursed on our pharmaceutical benefits scheme.

This takes place in MARCH 2017 (when the PBAC meeting takes place).

We have till the 8th February to actually provide Public commentary.

It’s your turn to have your say!

I encourage you to fill in the short form on the website  (http://www.health.gov.au/internet/main/publishing.nsf/Content/PBAC_online_submission_form) to explain why you think the pre-filled syringe of Methotrexate is important and how the decision to make it more accessible will impact your health and life.

Please do this now if it affects you. I’ve completed my submission.

The link again: http://www.health.gov.au/internet/main/publishing.nsf/Content/PBAC_online_submission_form