Multiple sclerosis: predicted versus actual analysis
Page last updated: 4 March 2016
Drug utilisation sub-committee (DUSC)
October 2015
Abstract
Purpose
To review the utilisation of PBS listed medicines for relapsing-remitting multiple sclerosis (RRMS), including an assessment of the predicted versus actual use of the oral therapies, dimethyl fumarate, teriflunomide and fingolimod.
Date of PBS listing of oral therapies
- Fingolimod – 1 September 2011.
- Dimethyl fumarate – 1 December 2013.
- Teriflunomide – 1 December 2013.
Data Source / methodology
Prescription data from the Department of Human Services (DHS). Data was extracted from January 2002 to the most currently available data (March 2015). Prescription data was based on the date of supply.
The medicines included in the analysis were interferon beta-1a, interferon beta-1b, glatiramer acetate, natalizumab, fingolimod, dimethyl fumarate and teriflunomide.
Key Findings
- 13,648 patients were treated with a PBS medicine for RRMS in 2014. Both the number of people starting treatment for the first time and the total number of people receiving treatment with PBS RRMS medicines has increased.
- There has been a significant rise in the number of prevalent patients since the introduction of oral RRMS therapy. The entry of dimethyl fumarate and teriflunomide appears to have grown the market, as the rate of growth of existing RRMS therapy has declined while the overall RRMS market has increased its rate of growth above that observed prior to the listing of these new oral therapies.
- Fingolimod is the most widely used drug when taking account of all patients on treatment. Dimethyl fumarate is the most frequently prescribed drug for patients new to RRMS therapy and in patients switching from prior RRMS therapy or returning to therapy after a treatment break.
- Patients appear to persist longer on oral compared to injectable therapy based on a length of treatment analysis of fingolimod. However, a median time on treatment had not been reached for fingolimod and a longer period of data is required to confirm this.
- In their first year of listing the utilisation of dimethyl fumarate has been higher than predicted while the usage of teriflunomide was substantially lower than expected.
- Instances of potential co-administered RRMS therapies were found to be negligible (<1%).
- Expenditure on RRMS medicines has continued to grow. This was mainly driven by an increasing utilisation of the oral therapies fingolimod and dimethyl fumarate with a decline in the use of injectable therapy.
Full Report
