Pharmaceutical benefits - Palliative care items
The PBS website lists preparations which may be prescribed specifically for patients receiving palliative care:
Ref: The Pharmaceutial Benefits Scheme. Browse by Palliative Care [Internet]. Commonwealth of Australia; [cited 2015 Mar 6].
Special Access Scheme (SAS) - Accessing medications not on the PBS
refers to arrangements which provide for the import and / or supply of an unapproved therapeutic good for a single patient, on a case by case basis. Palliative care patients meet the criteria for category A. Category A patients are defined as 'persons who are seriously ill with a condition from which death is reasonably likely to occur within a matter of months, or from which premature death is reasonably likely to occur in the absence of early treatment'.
Ref: Thererapeutic Goods Administration. Special access scheme [Internet]. Commonwealth of Australia; 2015 [updated 2015 Jan 28; cited 2015 Mar 6].
Editorial - Off-label prescribing
'Off-label prescribing means that the Therapeutic Goods Administration (TGA) has not approved the indication, route of administration or patient group. It does not mean that the TGA has rejected the indication. Commonly the TGA has not been asked to evaluate the indication.'
Ref: Day R. Off-label prescribing. Australian Prescriber. 2013 Dec;36(6):182-3.
Discussion paper - Use of 'off label' or drugs beyond licence in pain medicine
Use of 'off label' or drugs beyond licence in pain medicine (449kb pdf)
Discusses problems relating to off-label prescribing, which include 'a relative lack of readily available information for prescribers, nurses and consumers about the unapproved use of some medications and especially the higher risk of adverse drug reactions. Consumers should give fully informed consent to the use of off-label or unlicensed drug use'.
Clinicians may have conflicting ethical, legal and social responsibilities in regard to off-label prescribing. The discussion paper suggests a strategy to assist clinician decision making.
From: Faculty of Pain Medicine, Australian New Zealand College of Anaesthetists (2007)
Off Licence Prescribing in Palliative Care: A systematic review and narrative synthesis
Drug use beyond the licence in palliative care: A systematic review and narrative synthesis
Subscription or Institution access required
Ref: Hagemann V, Bausewein C, Remi C. Drug use beyond the licence in palliative care: A systematic review and narrative synthesis. Palliat Med. 2019 Jun;33(6):650-62.