The wording of the Pharmaceutical Benefits Scheme (PBS) requirements for pioglitazone and rosiglitazone changed on 1 August 2006. The changes are intended to simplify the listings. The authority requirements for the glitazones have not changed.
As shown in the table below, both pioglitazone and rosiglitazone are PBS listed (authority required) for dual oral therapy with metformin or a sulfonylurea, and in combination with insulin. Only rosiglitazone is listed for triple oral therapy with metformin and a sulfonylurea.
To be eligible for initiation of a PBS-subsidised glitazone, patients must have a glycosylated haemoglobin (HbA1c) level > 7%. The HbA1c level, which must have been measured within the 4 months preceding the application, must be provided. A provision has been added to the authority listing to exempt from this requirement patients in whom HbA1c testing is likely to be inaccurate
(for example, those with thalassaemia minor). For these patients, results of blood glucose monitoring over 2 weeks, during which more than 20% of results showed a blood glucose concentration above 10 mmol/L, will be accepted.
PBS-listed indications of the glitazones
|
|
Pioglitazone
(Actos)
|
Rosiglitazone
(Avandia)
|
|---|
|
Monotherapy
|
No |
No |
Dual oral therapy
(with metformin or a sulfonylurea)
|
Yes |
Yes |
Triple oral therapy
(with metformin and a sulfonylurea)
|
No |
Yes |
|
Combination with insulin
|
Yes |
Yes |
