Breast cancer and endometriosis drug Zoladex is being withdrawn from the Australian market, potentially leaving thousands of women without vital treatment. Manufactured by AstraZeneca, Zoladex (goserelin 3.6mg implant) will no longer be available under the Pharmaceutical Benefits Scheme (PBS) or privately from November, with a six-month grace period for existing patients.
What is Zoladex?
Zoladex is a hormone therapy that suppresses ovarian oestrogen production. It is used to treat hormone receptor-positive breast cancer, endometriosis pain, and for fertility preservation during chemotherapy. The monthly implant is inserted under the skin. Breast Cancer Network Australia (BCNA) estimates about 7,000 women with breast cancer use it annually, with 94,000 prescriptions filled in the last 18 months.
Why is it being removed?
Professor Nial Wheate from Macquarie University says the decision is likely commercial, as AstraZeneca focuses on a higher-dose 10.8mg implant (used for prostate cancer) administered every three months. The PBS pays $213.50 for the 3.6mg dose versus $714.89 for the 10.8mg, while US prices are significantly higher. AstraZeneca cited lack of commercial viability, but BCNA's Vicki Durston criticizes the lack of transparency. The Therapeutic Goods Administration (TGA) confirms the company's reasoning, but the decision is not directly linked to US tariffs or pricing policies.
Impact on existing patients
AstraZeneca has applied to list the higher-dose implant for breast cancer and endometriosis. It will provide free access to the monthly implant for eligible patients for six months after discontinuation. However, Dr. Nisha Khot, president of RANZCOG, warns that women may face limited options: paying for the higher dose, or using alternative pain management that may be less effective. Durston notes that the three-month dose may not work for all, especially those using aromatase inhibitors, and there is insufficient evidence for its efficacy in some cases.
Concerns about other drugs
BCNA reports delays in listing other critical breast cancer drugs on the PBS, attributed to global uncertainty and US pricing policies. Independent MP Monique Ryan has written to the health minister, calling for reform after a 2024 review aimed at improving medicine access. The Department of Health says it cannot compel AstraZeneca to keep the drug on the PBS but is exploring options to mitigate the impact.
