P48 Clinical update: ivermectin access for scabies improved through the pharmaceutical benefits scheme change in Australia

Abstract Scabies is estimated to affect 455 million people worldwide and a neglected tropical disease that endemic in northern Australia. Indigenous communities Australia are reported have some of the highest rates scabies Pacific, with recent prevalence be as high 25%, secondary complications including rheumatic heart poststreptococcal glomerulonephritis. However, burden skin still under-reported under-represented on national policy agenda. It essential consider public health strategies therapeutic opportunities address minimize serious contribute life expectancy gap exists between aboriginal Torres Strait Islander other Australians. Considering clinical need patient population, management highlights impracticality tolerability issues experienced, topical permethrin 5% cream sole first-line treatment option use ivermectin only second-line after failure cream. This especially important poor medication access well known perpetuate cycle inequity A multistakeholder submission Pharmaceutical Benefits Advisory Committee was developed support change listing Scheme (PBS) Australia, recommend for The PBS successfully changed 9 months review, from 1 April 2022, oral has been listed anticipated prescribing will large impact small number Australians who face significant disadvantages improve manage effectively condition disproportionately affects First Nations successful occurred ahead release new edition Australian guidelines, which at time writing scheduled released early 2023. updated guidelines include co-first-line alongside scabies, addition considering an ivermectin-based mass-drug administration programme regions > 10%, recommended by World Health Organization.