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 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 question to the PBAC

Sir, - As I understand it, the pundits now take the view that triple antigen should be used (in the absence of nasty reactions or contraindications) up until the age of 8 years. This virtually makes CDT redundant as they recommend adult doses after 8 years.

Is it therefore not time that triple antigen ampoules be included in the list of Emergency Drug (Doctor's Bag) Supplies?

J.H.W. Birrell
General Practitioner
Point Lonsdale, Vic.

PBAC response

Triple antigen is not appropriate for inclusion in the Emergency Drug Supplies list as it is not an item given in an emergency situation. Triple antigen is a vaccine for routine immunisation.

Tetanus vaccine may be used in an emergency and there is a long history why plain tetanus was replaced by tetanus -diphtheria.

The listings of vaccines for childhood immunisation were most recently reviewed by the Pharmaceutical Benefits Advisory Committee following a request to consider deleting these preparations from the Pharmaceutical Benefits Scheme. The Committee was advised that, in order to facilitate childhood immunisation, vaccines would be supplied free to immunisation providers, including general practitioners, through changed procedures not involving the Pharmaceutical Benefits Scheme. At the time, the Committee was not inclined to delete these items from the Scheme until alterations to the supply of triple antigen and CDT were well established. After this, the matter would be reconsidered.

Funding is now provided by the Commonwealth to the State governments for the supply of these vaccines. An immunisation co-ordinator in each State is responsible for this process.

Under these circumstances, it would be more appropriate for medical practitioners to secure supplies of triple antigen in this way.