Pharmaceutical Product Update Meeting — GP practice rep visit

Recorded: Tuesday 6 October 2026, 1:02 pm AEST (Otter, 20 min)
Format: a pharmaceutical representative's lunchtime visit to a Gold Coast general practice, with the GP adding clinical context.
Products covered: dienogest for endometriosis, the drospirenone combined pills, a new non-steroidal eczema cream, and an ultra-potent topical steroid for vulval lichen sclerosus.

1. Endometriosis: dienogest 2 mg (Visanne)

• What it is: a progestogen taken as one 2 mg tablet daily. The GP summarised its profile as progestogenic with anti-androgenic activity and no androgenic or glucocorticoid activity.
• Indication: pain from endometriosis and reduction of endometriotic lesions.
• PBS: the rep said it is now PBS-listed and that pharmacies are starting to stock it.
• Diagnosis: the rep said a confirmed (surgical) diagnosis is not needed. That would let GPs start it for a woman who is still waiting for investigations or a specialist appointment. Check the actual PBS restriction wording before relying on this.
• Pain: the rep claimed about a 40% reduction in pain within the first two weeks.
• Lesions: the rep claimed lesion reduction over 24 weeks, from an average stage 3 to stage 1.9 in the leaflet data.
• Duration: the rep said it can be given for up to 12 months and was unsure about longer use. Check the Product Information on longer-term use.
• Not a contraceptive: it is not indicated for contraception and not indicated with combined hormonal contraceptives. Women who need contraception need a separate, non-hormonal or compatible method.
• Use with the Mirena: the rep said, explicitly not as a promotional claim, that some specialists add dienogest to a levonorgestrel IUD (Mirena).
• How it differs from Slinda (drospirenone-only pill): Slinda is a contraceptive and dienogest is not. They also differ in mode of action and licensed indication.
• Practical GP take-away: an option for endometriosis-type pain in women who don't need hormonal contraception, for example younger patients who aren't sexually active, or women already using non-hormonal contraception. It can bridge the wait for gynaecology or pain specialist review. The GP planned to consider it for a patient with endometriosis pain who is seeing a pain specialist.

2. Drospirenone combined pills (Yaz and Yasmin)

• Both pills contain drospirenone with ethinylestradiol. The rep said they are now PBS-listed, where they used to be expensive private scripts.
• The GP noted they work well for women with acne. Because of the old cost, GPs often chose cheaper pills before.
• The rep highlighted their use in premenstrual dysphoric disorder (PMDD), linked to drospirenone's anti-mineralocorticoid effect on fluid retention and bloating.
• The rep left samples and patient information swatches.

3. New non-steroidal eczema cream (name unclear)

The transcript and Otter's summary garble this name ("Zematosk", "decollevus", "Delgocortolivane"). Confirm the exact product (brand and active) with the company before quoting it. Details as stated:

• PBS: listed from 1 October 2026. The rep said specialists previously had to have it compounded.
• Use: treating eczema flares on any part of the body, including the face, eyelids and flexures such as the elbows.
• Age: TGA-approved for 16 years and over. The rep said the PBS listing has no age criterion, but 16+ is the sensible floor.
• Comparison: the rep compared its efficacy with pimecrolimus (Elidel) and positioned it alongside tacrolimus. Unlike those, it can be used on large areas below the neck.
• Pack and cost: a 30 g tube, about $20–25 to the patient on the PBS, prescribed with one repeat (60 g total).
• Response: improvement expected within about a week and clearance within about six weeks, per the rep's graphs.
• Maintenance: after clearance, twice-weekly application, for example Mondays and Thursdays, for patients with frequent flares. If a flare recurs and they have run out, start a new course.
• Samples: 10 g sample tubes are now available, and the GP accepted samples.
• GP context: long waits for local dermatologists make a GP-prescribable, face-safe non-steroidal option valuable. Severe atopic eczema is now treated with biologics (fortnightly injections), which the GP described as transformative.

4. Ultra-potent topical steroid for vulval lichen sclerosus

The transcript names this "Zobet". It appears to be a clobetasol-class ultra-potent topical corticosteroid; confirm the exact product. The GP explained its use, and another rep from the company (Tim) had arranged a gynaecology education meeting on it.

• Indication focus: long-term maintenance treatment of vulval lichen sclerosus. It has broader ultra-potent steroid indications, but gynaecologists favour it for lichen sclerosus.
• Why treat firmly: lichen sclerosus causes severe itch, scarring and architectural change. Chronic untreated inflammation carries a risk of squamous cell carcinoma. Controlling inflammation reduces itch, scarring and that risk.
• Dose: a pea-sized amount, not a fingertip unit or a "peanut". It is applied as directed and continued long term, not stopped after a couple of weeks.
• Safety framing: used in small amounts, it reduces pain and inflammation while protecting fragile vulval skin.
• Referral: if a patient isn't improving on long-term steroid, refer to gynaecology or dermatology for biopsy to confirm the diagnosis and exclude other pathology. Then continue maintenance in general practice.
• How common: the GP said lichen sclerosus is relatively common in a practice with many female patients, not a specialist rarity.
• The GP noted this product is PBS-listed and, in their experience, works better than the other potent steroids used before.

Questions the GP asked

• How long can dienogest be given? (Rep: up to 12 months.)
• How does dienogest differ from Slinda? (Slinda is contraceptive; dienogest is not.)
• What is the minimum age for the eczema cream? (TGA 16+.)
• Can the eczema cream go on the eyelids? (Yes; the rep said face and eyelids are within its indication.)

Key take-aways for GPs

1. Dienogest 2 mg daily is a PBS option for endometriosis pain and lesions. It is not a contraceptive, so plan contraception separately. Check the PBS restriction about diagnosis.
2. The drospirenone combined pills Yaz and Yasmin are now more affordable on the PBS and suit women with acne or PMDD.
3. A new PBS-listed non-steroidal eczema cream (16+, from 1 Oct 2026) covers the face and eyelids. It comes as a 30 g tube with one repeat, with twice-weekly maintenance. Confirm the exact product name.
4. For vulval lichen sclerosus, use a pea-sized ultra-potent steroid as long-term maintenance, and refer for biopsy if it isn't responding.

Source: Otter recording "Pharmaceutical Product Update Meeting", 6 Oct 2026 (id wEfC1xo7EbZ7sOF6Bv_c6pUUAio). Speakers aren't named in the recording. Off-topic chat, gossip about named local specialists, and personal anecdotes are left out.