bDMARDs for psoriatic arthritis: utilisation analysis
Page last updated: 4 March 2016
Drug utilisation sub-committee (DUSC)
October 2015
Abstract
Purpose
To examine the PBS utilisation of biological disease modifying anti-rheumatic drugs (bDMARDs) for the treatment of psoriatic arthritis.
Date of listing on the Pharmaceutical Benefits Scheme (PBS)
- Adalimumab: 1 August 2006
- Etanercept: 1 August 2006
- Infliximab: 1 August 2006
- Golimumab: 1 August 2010
- Certolizumab pegol: 1 April 2015
Data Source / methodology
The Department of Human Services (DHS) Authority Approvals database was used for the majority of the analyses. The DHS prescription database and DUSC Highly Specialised Drugs database were used for prescription count and expenditure analyses.
Key Findings
- The number of patients on bDMARD treatment for psoriatic arthritis has increased from the time of listing, from about 900 in 2007 to nearly 5,000 in 2014.
- The number of new patients per year has also increased from about 570 in 2007 to about 1,000 in 2014 with no indication of stabilising.
- Adalimumab is the most commonly used bDMARD, followed by etanercept then golimumab. Infliximab has low and stable use. Certolizumab pegol was only recently listed and has yet to establish market share.
- Treatment continuation is high with 76-84% of new patients receiving a second authority approval for their initial bDMARD, and 94% receiving a second approval for any bDMARD.
- The majority of people remain on bDMARD therapy for long durations. For example, 73% of patients who began treatment in 2009 have received at least 10 authority approvals.
- Between 45% and 60% of patients who commenced bDMARD therapy prior to 2014 have received an authority for a single bDMARD, with 25-30% receiving authority approvals for one additional bDMARD, 10-15% for two additional bDMARDs, and 3-7% for three or more bDMARDs.
- Commonwealth expenditure increased by between $5 million and $10 million per year in for first six years of listing, and increased by $12 million in the seventh year, and $14 million in the eighth year of listing (to 30 September 2014). In 2014, Commonwealth expenditure on bDMARDs for psoriatic arthritis was $86.5 million.
Full Report
