Internal medicine journal
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Internal medicine journal · Jan 2025
ReviewPatient-driven personal importation in the face of cost barriers to care: can we do better?
Australia has a robust public health system that helps to make medicines affordable. However, evidence shows that a significant proportion of Australians still cannot afford medicines prescribed to them and that some patients import medicines from abroad as a result. ⋯ Although personal importation is the most obvious option, regulation leaves scope for other possibilities. We propose that guidance should be developed to help physicians address cost-related medicine non-adherence in practice and to help them understand their options and how to navigate them at the individual, speciality and professional levels.
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Internal medicine journal · Jan 2025
Real-world impact of pembrolizumab availability for deficient mismatch repair metastatic colorectal cancer.
Immunotherapy has emerged as a standard treatment for deficient mismatch repair (dMMR) metastatic colorectal cancer (mCRC). Pembrolizumab became widely available as a first-line (1L) option in Australia following the Pharmaceutical Benefits Scheme (PBS) listing in August 2021. The uptake of new treatment options can be lengthy. ⋯ Previously reported associations of dMMR were observed. The higher-than-expected proportion of patients with dMMR is likely driven by the inclusion of older patients in this real-world study. Many patients were able to access immunotherapy prior to PBS listing, potentially through trials or access programs. Early uptake of pembrolizumab following PBS listing has been high, and this effective and well-tolerated option has increased the proportion of elderly patients receiving active therapy.