Listing of Pharmaceutical Benefits (NHL) - Schedule 4 part 1

Complex gastro-oesophageal reflux disease (GORD)

One of: (1) establishment of symptom control, (2) maintenance treatment, (3) re-establishment of symptom control

The condition must be stable for the prescriber to consider the listed maximum quantity of this medicine suitable for this patient; AND

Must be treated by a gastroenterologist; or

Must be treated by a surgeon with expertise in the upper gastrointestinal tract; AND

The treatment must be: (i) the sole PBS-subsidised proton pump inhibitor (PPI) for this condition, (ii) the sole strength of this PPI, (iii) the sole form of PPI; AND

Patient must have symptoms inadequately controlled with each of: (i) a high dose proton pump inhibitor (PPI) administered once daily, (ii) a standard dose PPI administered twice daily; treatment is for: (1) establishment of symptom control; or

Patient must be assessed for the risks/benefits of a step-down in dosing from a high dose PPI administered twice daily, with the determination being that the risks outweigh the benefits; treatment is for: (2) maintenance treatment; or

Patient must have trialled a step-down in dosing, yet symptoms have re-emerged/worsened; treatment is for: (3) re-establishment of symptom control; or

Patient must have trialled a step-down in dosing, with symptoms adequately managed with once daily dosing; treatment is for: (2) maintenance treatment, but with the quantity sought in this authority application being up to 2 packs per dispensing.

Check patient adherence to any preceding PPI treatment regimen. Exclude non-adherence as a cause of inadequate control before accessing treatment under this restriction.