Readers are invited to write in with their questions about decisions of the Pharmaceutical Benefits Advisory Committee (PBAC). Australian Prescriber publishes selected questions from readers, together with answers from the PBAC. Questions may address issues such as regulatory decisions, pharmaceutical benefits listings and withdrawals.

This exclusive arrangement helps Australian Prescriber readers understand how the contents of the Pharmaceutical Benefits Scheme (PBS, see www.pbs.gov.au) are determined.

Letters and responses are reviewed by the Editorial Executive Committee and may be edited before publication. It may not be possible to reply to all individual questions.

Your questions to the PBAC

I found the article on influenza vaccination (Aust Prescr 2007;30:35-7) very informative. I would like clarification on the eligibility of healthcare workers to receive influenza vaccination under the Pharmaceutical Benefits Scheme (PBS). My copy of the Schedule states that influenza vaccine is a restricted benefit for 'Persons at special risk of adverse consequences from infections of the lower respiratory tract'. My understanding of this restriction means that only individuals who are themselves at risk are eligible for PBS subsidy. The fact that immunisation prevents disease in someone else is not an indication for PBS subsidy, by my understanding. I hope I can prescribe it for health workers on the PBS so I am asking for further elucidation.

Peter Annetts
General Practitioner
Glen Innes, NSW

PBAC response:

Dr Annett's understanding of the restriction on influenza vaccine is correct - only those individuals who are themselves at special risk of adverse consequences from infections of the lower respiratory tract are eligible for subsidy under the PBS.

Certainly, use in healthcare workers who are contacts of high risk patients is recommended by the National Health and Medical Research Council immunisation guidelines. However, subsidy of the influenza vaccine for this occupation-related indication is not covered by the Commonwealth, but by decisions made at the state, territory or employer level. For example, in the Australian Capital Territory (ACT) public hospitals will cover the cost of vaccinating their own health workers who want it, nursing home owners provide the same for their staff, while the ACT Health Department operates a program to supply the vaccine free of charge to staff working in general practice. In summary, the subsidy of influenza vaccine for an individual patient at risk is covered by the PBS, while for healthcare workers the subsidy is a matter for their employer.