Industry rep update: dienogest for endometriosis, tacrolimus ointment for eczema, clobetasol for lichen sclerosus and drospirenone pills on the PBS
A pharmaceutical representative's lunchtime visit to a Gold Coast general practice: Visanne (dienogest 2 mg) for endometriosis, aZematop (tacrolimus 0.1% ointment) newly PBS-listed for atopic dermatitis, Xobet (clobetasol propionate 0.05%) and how the GPs use it for lichen sclerosus, and Yaz and Yasmin on the PBS. We report what the rep claimed, add the GPs' own clinical comments, and cross-check the PBS facts.
This was a pharmaceutical representative presentation in the practice, not an independent CPD activity. Product claims below are the representative's claims and may reflect promotional material. Where we checked public PBS listings (as at 21 October 2026), we say so separately. Always rely on the product information and independent guidance.
- Presenter
- Unnamed pharmaceutical representative. Describes a physiology background, earlier work in cardiovascular medicine and a current women's health and dermatology portfolio. No name or company was stated in the transcript.
- Practice clinicians
- Unnamed GPs from the practice asked questions and added clinical comments, especially on dienogest, lichen sclerosus and acne. Their names are not given.
- Session context
- Otter title Pharmaceutical Product Update Meeting · id
wEfC1xo7EbZ7sOF6Bv_c6pUUAio· 20 min. Otter split the audio across seven speaker labels. Social chat, sample logistics, specialist waiting-list talk (including named local dermatologists) and personal anecdotes have been left out.
At a glance
| Product | What the rep said | Our PBS check (21 Oct 2026) |
|---|---|---|
| Visanne (dienogest 2 mg tablet) | For endometriosis; "came onto the PBS"; once daily; not a contraceptive | Listed, Authority Required (Streamlined), indication endometriosis; 28 tablets with 5 repeats (item 14667Y). Listed since late 2024. |
| aZematop (tacrolimus 0.1% ointment, 30 g) | PBS from 1 October 2026; age 16 and over; any body site including face and eyelids; one repeat; about $25 | Listed 1 Oct 2026, Authority Required, moderate to severe atopic dermatitis, flare treatment, 1 repeat, general charge $25 (item 15542B) |
| Xobet (clobetasol propionate 0.05%) | Ultra-potent steroid with several indications | Ointment 30 g listed (Restricted Benefit, corticosteroid-responsive dermatoses, no repeats; item 14808J), since May 2025 |
| Yaz and Yasmin (drospirenone with ethinylestradiol) | Now on the PBS | Listed from 1 March 2025 (Yaz item 14709E, unrestricted) |
Visanne (dienogest) for endometriosis
What the rep claimed
- A once-daily 2 mg progestogen tablet for endometriosis, now on the PBS, so pharmacies are starting to stock it.
- "You do not need a diagnosis" to start it: useful while a patient waits for investigations or a specialist, or after other treatments have not helped. (See the caveat below: the PBS indication is endometriosis, so check the streamlined authority wording.)
- About 40% reduction in pain within the first two weeks, and lesion reduction over 24 weeks (described as going "from a stage three to a stage 1.9", which is unclear; see caveats).
- Can be given for up to 12 months; the rep was "not too certain" about longer use.
- Not a contraceptive, and not indicated for use with combined oral contraceptives.
- The rep had heard from pharmacies (and said they were not promoting this) that some specialists use it alongside a Mirena.
What the GPs added
- Dienogest has progestogenic activity with anti-androgenic activity and no androgenic or glucocorticoid activity.
- Asked how it differs from Slinda (drospirenone-only pill, transcribed "Slender"): Slinda is a contraceptive; dienogest is not, and works differently.
- One GP planned to consider it for a patient with endometriosis-related period pain already under a pain specialist.
aZematop (tacrolimus 0.1% ointment) for atopic dermatitis
The rep's main item. Tacrolimus ointment had long been compounded by specialists; the branded product (transcribed "zematosk", identified as aZematop) went onto the PBS on 1 October 2026. A GP noted this matters because non-steroid options had been limited.
What the rep claimed
- TGA-approved age: 16 and over. The rep said there were "no criteria on the PBS" beyond that. Our check: the PBS listing is Authority Required for moderate to severe atopic dermatitis (flare treatment), so there are criteria.
- Use on any part of the body, including the face and eyelids and large areas below the neck, which the rep presented as the key difference from Elidel (pimecrolimus). Efficacy was compared with pimecrolimus in the marketing material.
- 30 g tube, about $25 on the PBS, one repeat (60 g in total).
- Improvement within a week and clearance within six weeks (from the leaflet graphs).
- Maintenance for frequent flarers: twice weekly, for example Monday and Thursday; if a flare returns, restart flare treatment.
- 10 g sample tubes are available.
Xobet (clobetasol) and lichen sclerosus
The rep showed Xobet (transcribed "Zobet"), an ultra-potent topical corticosteroid, and asked the GPs where they use it. The most useful teaching in the session came from one of the GPs:
- Mainly for lichen sclerosus, including vulval lichen sclerosus, which this GP sees often in female patients.
- It is long-term maintenance treatment, not a couple of weeks: a pea-sized amount applied once.
- The condition causes severe itch; ongoing itch and inflammation can lead to cell changes and squamous cell carcinoma, which is why a strong steroid is used. Treatment reduces itch, inflammation and scarring while protecting fragile skin.
- Typical pathway: if potent steroids are not working, refer; the specialist biopsies to confirm, and the GP then continues treatment.
- The GP said gynaecology meetings had described this product as working particularly well for lichen sclerosus.
Yaz and Yasmin on the PBS
The rep briefly noted that Yaz and Yasmin (drospirenone with ethinylestradiol) are now on the PBS and brought pill swatches. The GPs commented:
- It works very well for acne; it used to be expensive, so cheaper alternatives were often used instead.
- Useful in premenstrual dysphoric disorder (PMDD); the rep linked this to drospirenone's effect on fluid retention.
The PBS lists drospirenone with ethinylestradiol from 1 March 2025. The PBS medicine status page lists the uses as oral contraception, moderate acne in women who want oral contraception, and PMDD in women who have chosen an oral contraceptive. Drospirenone-containing pills carry a slightly higher clot risk than some other progestogens, so assess VTE risk as usual (this point is from public information, not from the meeting).
A GP aside: biologics for severe eczema
One GP reflected that for a long time there was little for severe eczema, and now biologics given as injections every two weeks have "changed a lot"; the practice has a couple of patients on them. No product was named. They also noted that chronic eczema that is not properly treated becomes thickened.
GP takeaways
1. Dienogest is a PBS option for endometriosis pain; it is not contraception, so ask about contraceptive needs first. Check the streamlined authority wording before relying on the "no diagnosis needed" claim.
2. Tacrolimus 0.1% ointment (aZematop) is now PBS-subsidised for moderate to severe atopic dermatitis in people 16 and over under an Authority Required listing; it can be used on the face and eyelids.
3. For lichen sclerosus, ultra-potent steroid with a pea-sized amount, biopsy confirmation via a specialist when needed, and long-term follow-up for itch, scarring and SCC risk.
4. Yaz and Yasmin are cheaper on the PBS and are worth considering for acne or PMDD in women wanting the pill.
Transcript caveats
Speakers: no names were given for the representative or the GPs. A colleague rep "Tim" was mentioned in passing. Otter's seven speaker labels mix voices; GP comments are attributed by content.
Names identified: "Visan/Vasan/basalis" = Visanne; "Dinogest" = dienogest; "zematosk/zener pop" = aZematop (tacrolimus 0.1%; confirmed by the 1 October 2026 PBS listing); "Aladel/Alida" = Elidel (pimecrolimus); "Zobet" = Xobet (clobetasol propionate 0.05%); "Yasin Yasmin/Yas" = Yaz and Yasmin; "Slender" = Slinda (drospirenone-only pill, likely); "Marina" = Mirena (likely); "asparagine/drospherenone" = drospirenone.
Not identified (not named on this page): "Raiko" (a product the rep said specialists sometimes add); "decollevus"; "polio/Prolya" in the rep's portfolio (possibly Prolia, but not discussed); "stale and dye" (a cheaper pill alternative); "fulcrum" in the lichen sclerosus discussion.
Claims not verified: the 40% pain reduction in two weeks, the lesion "stage three to 1.9" figure (scale not stated), the two-phase or endometrium-specific action, the 12-month duration, "no diagnosis needed", and aZematop's one-week and six-week timings are the representative's words. The rep's "no criteria on the PBS" for aZematop conflicts with the Authority Required listing. Whether the separate maintenance-phase PBS listing applies was not checked; the item we found is for flare treatment. "Expanding it in 2027" was unclear.