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MS medicines confirmed on PBS: what the ocrelizumab decision means

By Dr HB Lo, FACRRM 4 min read
Verdict Yes — worth knowing about

Two MS medicines — ocrelizumab (Ocrevus) and ofatumumab (Kesimpta) — remain on the Pharmaceutical Benefits Scheme following confirmation by Federal Health Minister Mark Butler. Without PBS coverage, either medicine would cost approximately $30,000 per course. The reprieve follows weeks of uncertainty triggered when a lower-priced competitor gained PBS listing, which under reference pricing rules could have pulled benchmark pricing down for the whole class. A PBAC review of high-efficacy MS medicines is forthcoming, but access is confirmed for now.

What just happened

Two of the highest-efficacy medicines available for relapsing multiple sclerosis are staying on Australia’s Pharmaceutical Benefits Scheme.

Federal Health Minister Mark Butler confirmed this week that ocrelizumab (brand name Ocrevus, made by Roche) and ofatumumab (Kesimpta, Novartis) retain their PBS listings — ending weeks of uncertainty that had unsettled neurologists and their patients in equal measure.

Without PBS coverage, either medicine costs approximately $30,000 per course. That figure is beyond reach for most households. The PBS listing means eligible patients pay the standard co-payment — currently around $31 for concession cardholders — and the Commonwealth covers the remainder.

Multiple sclerosis affects more than 33,000 Australians. Around 85% are diagnosed with relapsing-remitting disease — the form where symptoms appear in episodes, then partially or fully resolve between them. About half of all Australians receiving treatment for relapsing MS are currently on one of these two anti-CD20 medicines, which work by targeting B cells in the autoimmune process that damages the myelin sheath protecting nerve fibres.

MS is diagnosed three times more often in women than men, typically between the ages of 20 and 40 — the years of peak career, family, and financial responsibility. The PBS listing is not an abstract policy outcome. For many of these women and their families, it is the difference between staying on a medicine that is working and having to stop.

The both-and

Why this review happened at all

The uncertainty arose from how the PBS handles pricing when similar medicines compete for the same indication. In late 2025, a third anti-CD20 medicine — ublituximab (Briumvi) — gained PBS listing at a substantially lower price than either ocrelizumab or ofatumumab. Under the PBS reference pricing framework, comparable medicines can be grouped together, with the lowest-priced product setting a benchmark that pulls reimbursement rates down for the whole class.

That pricing mechanism triggered a review of whether ocrelizumab and ofatumumab could remain on the PBS at their existing prices. Roche Australia’s General Manager, Dr Nic Horridge, described the proposed price cut as “entirely unfeasible” and criticised the process publicly.

The reference pricing logic is reasonable in principle: if a cheaper medicine does the same job, the scheme should not pay more than necessary. The complication is that clinical equivalence across a drug class is rarely perfect. Ocrelizumab and ofatumumab are not identical to ublituximab in dosing schedule, administration route, or the evidence base supporting them. Neurologists need genuine options across this group to manage individual patients appropriately.

What “reprieve” actually means

The Minister’s confirmation of continued access is welcome. But it arrives with a caveat: the government has asked the Pharmaceutical Benefits Advisory Committee to conduct a formal review examining how high-efficacy MS medicines are used on the PBS, and whether their listings reflect current clinical evidence.

A PBAC review is not a delisting. It is a structured reconsideration that may lead to recommendations about therapeutic positioning, pricing adjustments, or access criteria — but any outcome requires a further government decision before anything changes for patients. The terms of reference and timing for this review have not yet been announced.

Sharlene Brown, Director at MS Australia, responded to the reprieve with measured relief: “Continued PBS access means people can keep working with their neurologists to choose the treatment that is right for them, without the fear that effective options will be placed out of reach.”

That is the right framing. This is a reprieve — not a permanent resolution. The PBAC review keeps the question open.

The broader pattern

MS prevalence in Australia has grown 77% since 2010, and the annual economic cost is estimated at around $3 billion nationally — approximately $80,000 per person. The condition is not rare, and the medicines managing it are not cheap. The tension between what patients need and what a national drug scheme can afford without reference pricing frameworks is structural, not incidental.

This week’s decision acknowledges that pharmaceutical access cannot be reduced to price alone when the medicines involved manage a complex, lifelong autoimmune condition. A patient who has been stable on ocrelizumab for three years, with no new MRI lesions and a functioning career, is not in the same clinical position as someone beginning treatment for the first time. Abrupt disruption of effective therapy carries its own consequences — neurological, financial, and emotional.

My two cents

The reference pricing debate will not end with this reprieve. The PBAC review is coming, and its outcome matters.

What this week tells us is that patient advocacy works. MS Australia’s direct communication with the Minister, combined with the clinical weight of neurologists nationally, produced a clear response. The 33,000 Australians managing MS — three-quarters of them women — are not a small or invisible constituency.

If you are currently on ocrelizumab or ofatumumab: no immediate action is needed. Your next neurology appointment is the right time to ask about the upcoming PBAC review and what it might mean for your specific situation. Australian MS neurologists will be following this process closely.

If you have been told a cost review might affect your access and have not received an update: your neurologist’s rooms or the MS Australia helpline (1800 042 138) can confirm current status.

Verdict: yes — worth knowing about.

Sources cited

  1. “PBS reprieve for MS blockbusters.” Medical Republic, 17 July 2026. https://www.medicalrepublic.com.au/pbs-reprieve-for-ms-blockbusters/127428
  2. Services Australia. Pharmaceutical Benefits Scheme. https://www.servicesaustralia.gov.au/pharmaceutical-benefits-scheme
  3. MS Australia. About MS. https://www.msaustralia.org.au/about-ms/
  4. Pharmaceutical Benefits Advisory Committee (PBAC). https://www.pbs.gov.au/info/industry/listing/elements/pbac-meetings

Frequently asked questions

  • If I am on ocrelizumab or ofatumumab, do I need to do anything now?

    No immediate action is required. Both medicines remain available at PBS-subsidised prices. Continue treatment as planned and raise any questions at your next neurology appointment. If you have concerns about the upcoming PBAC review, your neurologist is the right person to ask — they will be informed of any changes before they affect prescriptions.

  • What is the PBAC review and does it mean my medicine might be delisted?

    The Pharmaceutical Benefits Advisory Committee (PBAC) has been asked to review how high-efficacy MS medicines are used on the PBS. A review is not a delisting — it typically leads to recommendations about how medicines are positioned relative to each other. Any outcome requires a further government decision, announced well in advance. Your neurologist will be informed before anything changes.