The Pharmaceutical Benefits Advisory Committee (PBAC) has recommended that the federal government fund triptorelin for unrestricted use, which would cover treatment for breast cancer, endometriosis, and gender dysphoria. If adopted, this would mark the first time gender-affirming care is funded through the Pharmaceutical Benefits Scheme (PBS).
Urgent Meeting in Response to Zoladex Withdrawal
The committee met urgently in July after AstraZeneca announced it would remove Zoladex from the market, potentially leaving more than 7,500 women with breast cancer without an alternative treatment. Triptorelin, PBS-listed since 2006 for prostate cancer, blocks the release of oestrogen and testosterone, similar to Zoladex. Both drugs are considered essential medicines by the World Health Organization and are used for cancer treatment, fertility preservation, endometriosis, and to block puberty in cases of precocious puberty or gender-affirming care.
The government has historically implemented PBAC recommendations, so the listing is likely to proceed. If approved, the expanded PBS coverage would take effect in November.
Patient Advocacy and Medical Perspectives
Vicki Durston, director of policy and advocacy at Breast Cancer Network Australia, called the decision “a significant step forward” and said access to the drug could mean the difference between life and death for some patients. She noted that some women had already chosen to have their ovaries removed due to supply uncertainty.
Marilla Druitt, Victorian state chair of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, said it was unclear whether triptorelin would work exactly like Zoladex but that the decision was likely positive for endometriosis and pelvic pain patients. “I’m glad we’ve got an alternative,” she said. “That’s fantastic, and it remains to be seen whether or not it will be as good, but pain is so complex, pain is a really hard thing to study because it’s got so many contributors.” She emphasized the need for additional research after introduction.
Impact on Gender-Affirming Care and State Bans
If the listing is taken up, gender-affirming care would be funded by the federal taxpayer through the PBS for the first time, removing a financial barrier for transgender children in Queensland and the Northern Territory. In other jurisdictions, such care is already free through the public system. However, Queensland banned public hospitals from prescribing gender-affirming drugs to transgender children in January, affecting more than 491 patients on the waitlist at the state’s gender clinic. The ban was overturned by the supreme court but immediately reimposed. The Northern Territory imposed a similar ban in response.
Stuart Aitken, medical director of Gender Health Australia, said the decision sparked “absolute joy” in his patients. “It takes away a huge barrier to accessing evidence-based care,” he said. “It means that the ban has a very limited effect.”
Brisbane GP Fiona Bisshop from Stonewall Medical Center said a PBS listing would reduce the cost of private prescribing from about $3,000 a year to just $300, or $25 a week. “It kind of makes [the ban] a joke, really … it makes it laughable that the PBS is saying you can prescribe this for anything,” she said. Cost had been one of the primary obstacles to treatment in Queensland.
The state government’s own review of the treatments warned that the ban created legal, ethical, governance, regulatory, and oversight risks, including “inequity because of socioeconomic status or geographical location.” The review found low-quality but consistent evidence suggesting puberty blockers can reduce gender-related distress when carefully prescribed, and it did not recommend continuing the ban. Nevertheless, health minister Tim Nicholls extended the ban to at least 2031, pending a UK trial.
Triptorelin, like most drugs used in gender-affirming care, is prescribed off label and is not approved for that use by the Therapeutic Goods Administration. The expanded PBS coverage, if approved, would take effect in November, potentially reshaping access to essential treatments across Australia.
