Published: 1 October 2019

Consultations

Outcome of consultation on the changes to the prescribing restrictions of riluzole

In August 2019, Medsafe consulted with interested people regarding a change to the prescribing restrictions on riluzole, a glutamate agonist used in the management of amyotrophic lateral sclerosis (ALS). Currently, riluzole can only be prescribed by specialist physicians who care for patients with Motor Neurone Disease, neurologists and palliative care physicians.

Medsafe was approached by several clinicians requesting a change to these prescribing restrictions to improve access for riluzole for people with Motor Neurone Disease (MND) in the community, between specialist appointments. A change would also align with international practices for the prescribing of riluzole. The initial proposal was to allow GPs to continue to prescribe riluzole after an initial prescription from, and in collaboration with, a specialist.

28 submissions were received, all supportive of the change.

One submission noted that gerontologists care for people with MND, and they should be included in the group able to prescribe. Medsafe notes that the original definition of “physicians who care for patients with Motor Neurone Disease” can include gerontologists. No change is required.

One submission suggested that the prescribing GPs be limited to those with vocational registration. Medsafe considers that it is important for people with MND to have adequate access to riluzole, particularly in rural areas and therefore allowing authorised prescribers in collaboration with a specialist achieves this outcome, without additional risks.

Therefore, the prescribing restriction on riluzole is to be:

”Riluzole can only be prescribed by authorised prescribers where the prescribing decision is taken in collaboration with, or following consultation with, physicians who care for patients with Motor Neurone Disease, neurologists and palliative care physicians.”

The amended prescribing restriction takes effect on 7 October 2019.

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