Statement on PBS delisting of Fiasp insulin - 31 March 2023

The Australian Paediatric Society is disappointed at the Federal Government’s decision to reduce by 37% the rebate to the only ultra-fast insulin in market, that has led to Novo Nordisk making a commercial decision to withdraw the product Fiasp from the Pharmaceutical Benefits System on April 1st.

This Government action, taken to save a cost of $14 per script, is likely to cause significant harm to children, disruption to management of children with diabetes at school and it compounds family distress. Australia continues to perform poorly with outcomes for children with Type I compared to international benchmarks. Such action is inconsistent with the National Diabetes Strategy.

Ultra-fast insulins may be delivered immediately prior to eating, rather than the alternative insulins requiring the child to wait 15 minutes before eating. For children using a commonly used “Multiple Daily Injection” regimen, especially those at school, it is a significant imposition and risks food consumed before insulin starts working to rapidly increase blood glucose levels. This increases “blood glucose variability” and reduces the child’s “time in target glucose range”. Both outcomes have effects on learning and long-term harmful effects on blood vessels, risking damage to various body organs causing medical and emotional complications and potentially reducing the child’s life expectancy.

The decision by the Federal Government requires urgent review. The announcement on 17th March by Health Minister Butler is a true explanation of the standard process that occurs prior to a product without an alternative brand being deleted from the PBS. Fiasp will be available for “Supply Only” from April 1st and will be available for dispensing, but not for prescribing for a period of 6 months. Therefore, no children diagnosed with Type 1 Diabetes from tomorrow will have subsidized access to the only ultra-fast insulin available in Australia.

The Australian Paediatric Society advocates for urgent discussions between the Federal Government and NovoNordisk to address an illogical government financial decision that will significantly impact on children with Type 1 Diabetes along with many pregnant women (whose baby may be affected) and adults living with Type 1 Diabetes.

The need for a parliamentary inquiry into Type 1 Diabetes is now becoming critical.

APS FIASP Position Statement 31-03-2023159.39 KB