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In Australia, treatment access is subject to eligibility criteria initially established in 2004. Patients and their clinicians question why these criteria have remained unchanged despite significant progress in disease understanding.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>Appraise the clinical quality of the Australian treatment access criteria.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The Fabry Australia Medical Advisory Committee (<jats:italic>N<\/jats:italic> =\u20096) used the Appraisal of Guidelines for REsearch and Evaluation Global Rating Scale (AGREE II GRS) to assess the clinical quality of the current treatment eligibility criteria. They reviewed the literature, developed 17 clinical statements to help guide reforms of the eligibility criteria and achieved consensus (achievement of \u226575% agreement in the range 5\u20137 on a 7\u2010point Likert scale) through anonymous voting. The findings were applied to develop proposals for revised classification and treatment initiation criteria.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The current treatment eligibility criteria underperformed on the AGREE II GRS. They are pragmatic but out\u2010of\u2010step with contemporary data. Consensus was achieved on all 17 proposed clinical statements. There was strong agreement to differentiate classical male Fabry patients to facilitate timelier access to Fabry\u2010specific treatment. There was also agreement on the value of adopting relevant organ involvement criteria in classical female patients and patients with non\u2010classical disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Australian access criteria are misaligned with current clinical evidence. The clinical statements and proposed classification and initiation criteria should prompt discussions to support more equitable access to treatment and better align Australian practice with contemporary evidence and international guidelines.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.16327","type":"journal-article","created":{"date-parts":[[2024,1,12]],"date-time":"2024-01-12T05:35:23Z","timestamp":1705037723000},"page":"882-890","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Fabry\u2010specific treatment in Australia: time to align eligibility criteria with international best practices"],"prefix":"10.1111","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1297-8722","authenticated-orcid":false,"given":"Kathleen","family":"Nicholls","sequence":"first","affiliation":[{"name":"Department of Nephrology Royal Melbourne Hospital  Melbourne Victoria Australia"},{"name":"Department of Medicine The University of Melbourne  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6570-3028","authenticated-orcid":false,"given":"Charles","family":"Denaro","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Aged Care Royal Brisbane and Women's Hospital  Brisbane Queensland Australia"},{"name":"Academy of Medicine University of Queensland  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9700-7898","authenticated-orcid":false,"given":"Michel","family":"Tchan","sequence":"additional","affiliation":[{"name":"Department of Genetic Medicine Westmead Hospital  Sydney New South Wales Australia"},{"name":"Faculty of Medicine and Health University of Sydney  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5752-5698","authenticated-orcid":false,"given":"Carolyn","family":"Ellaway","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health University of Sydney  Sydney New South Wales Australia"},{"name":"Genetic Metabolic Disorders Service Sydney Children's Hospital Network  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5292-596X","authenticated-orcid":false,"given":"Drago","family":"Bratkovic","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Aged Care Women's and Children's Hospital  North Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sheridan","family":"Campbell","sequence":"additional","affiliation":[{"name":"Fabry Australia  Echuca Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megan","family":"Fookes","sequence":"additional","affiliation":[{"name":"Fabry Australia  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8922-7583","authenticated-orcid":false,"given":"Mark","family":"Thomas","sequence":"additional","affiliation":[{"name":"Department of Nephrology Royal Perth Hospital  Perth Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,1,11]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.revmed.2020.08.019"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40265-021-01486-1"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.3390\/biom11020271"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13023-015-0296-8"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/diseases9040072"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0244279"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/jmedgenet-2015-103486"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12882-020-01717-9"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13023-019-1290-3"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/cge.13999"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ymgme.2018.04.007"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ymgmr.2019.100454"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ymgme.2018.09.007"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1510198"},{"key":"e_1_2_8_16_1","unstructured":"Life Saving Drugs Program.Fabry disease \u2013 Initial application. 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