Zoladex 3 monthly available but not PBS covered for women

Question

I wanted to share something I recently learned as it might help ease the burden of regular monthly injections.

I recently learned that the goserelin injections many of us have monthly are actually available in a 3 monthly dose (10.8mg). I was a really hopeful thinking this could significantly reduce the stress, time and cost that comes with needing to have an injection every 4 weeks.

However, my Med Onc informed me that in Australia, the PBS doesn't subsidise the 3 monthly dose for women, although it does for men (prostate cancer). The reasoning given that there's `insufficient evidence of reliable suppression of serum oestradiol' in women.
What doesn't make sense is that there is evidence suggesting otherwise. Recent research indicates that the 3 monthly dose is non-inferior to the monthly dose for pre-menopausal women with breast cancer in terms of ovarian suppression.

For me, the monthly injections come with a real burden:

financially - GP visits and medication add up every month
time wise - frequent GP appointments and pharmacy trips take time out of the week.
physically and emotionally - injection itself is painful, it's a large slow release implant into the abdominal subcutaneous tissue.

The main alternative - surgical removal of the ovaries is obviously much more invasive and comes with it's own risks and long term consequences.

Given that the 3 monthly option is already in use, clinically tested and could ease the burden for many of us, I would really like to see equal PBS access for women.

I'm curious, has anyone else looked into this and how to go about taking action?

nwhite1 · Answer

ThanksChristina_BCNA​ that sounds promising. I wonder how they are progressing as it seems so unreasonable. FYI The recent study that the 3 month is non inferior to the monthly dose was published just last year.&nbsp;

christina_bcna · Answer

Thank you for sharing this NWhite1​ -&nbsp; it’s a really important issue, and many will relate to the burdens you’ve outlined. Our Policy &amp; Advocacy team is aware of PBS issues and are active in this space, I've passed this on to them to look into further so your experience can help inform their ongoing work :)

jaden · Answer

I had been on monthly zolodex since initial diagnosis for triple pos ILC stage 2. I just had oopherectomy last week as I preferred that to ongoing cost plus having another appt for 1-2 hrs at hosp every 4 wks and the pain of the injection. &nbsp;Cost of living is through the roof and I haven’t been well enough to work while on all this treatment. I’m so glad to not have to do the zolodex anymore, but acknowledge that having any surgery has risks that need to be weighed up by each person with their doctors.

nwhite1 · Answer

Hi Jade I know the monthly injection is awful and the fact there’s a 3 monthly dose not subsidized for women 😩. I have been driven to also go down the surgery track (menopause imminent but being 51 yo and on hormone blockers means can’t pinpoint how far away menopause is). Hope you are making a good recovery and one less thing you have to think about 😅