PBAC calls for consumer comment on Trulicity

Friday, 13 September 2019

The Pharmaceutical Benefits Advisory Committee (PBAC) has recently opened a period of consumer comments on Dulaglutide (Trulicity) and is interested in hearing from people living with type 2 diabetes, their family, friends and carers, healthcare professionals and patient or consumer groups about the medication being added to the PBS or being reimbursed by the Government.

The PBAC is interested in submissions which cover personal experience, potential benefits and the impact the listing may have on user’s quality of life.

Diabetes NSW & ACT recently lodged the following submission to the PBAC on behalf of our community. Submissions are open until 9 October 2019 and if you would like to add you voice to the discussion you can make a submission to the Department of Health online here.

Our submission

Diabetes NSW & ACT supports the change of listing of Dulaglutide (Trulicity) to Request on Authority (Streamlined) in conjunction with insulin.

Trulicity has provided an effective and easily used alternative for people living with type 2 diabetes since its introduction to the PBS.  The reduced frequency of injections and decrease in injection site reactions are both significant benefits of this medication.

The ease of use is particularly remarkable, and helpful to people with needle phobia.  The hidden needle significantly reduces the fear of self-injecting. This allows greater adherence and persistence of use, enabling greater control of blood glucose.

The change to Authority will allow people living with diabetes to experience the benefits of this medication in the most effective and consistent manner while still maintaining important safeguards.

With regards to use alongside insulin, a study introducing Dulaglutide weekly to Basal insulin (Eli Lilly AWARD-9) contrasted positively to the placebo, with much higher percentages of patients achieving HbA1c targets, and noticeable changes to HbA1c levels.  The weekly Dulaglutide 1.5 mg added to basal insulin is an efficacious and well tolerated treatment option for patients with type 2 diabetes.

The role of GLP-1 agonists, such as Dulaglutide, to decrease not just diabetes hospitalisations but other cause hospitalisations has been examined in a number of studies.

A US study of 6,718 adults concluded that the use of GLP-1 agonists together with insulin resulted in a 1.7 per cent decrease in hypoglycaemia, a 1.97 per cent decrease in pancreatic events, a 6.99 per cent decrease in all hospitalisations, and a 5.75 per cent decrease in diabetes hospitalisations.

A 2013 UK study (Yu) into the relationship between HbA1c and risk of all‐cause hospital admissions among people with Type 2 diabetes showed that for every 11mol/mol (1%) above 61mol/mol (1.1%), hospitalisation  rates increased by 6.3% for all-cause admissions, 6.4% for diabetes admissions and 15.9% for cardiovascular admissions.  Enabling better management of HbA1c levels will have a direct impact on hospitalisations.

Diabetes NSW & ACT supports the change of listing of Dulaglutide (Trulicity) as for certain patients it can support better diabetes management, resulting in fewer complications, and a reduction in diabetes related hospitalisation.


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