Metastatic prostate cancer: predicted versus actual analysis
Page last updated: 28 October 2016
Drug utilisation sub-committee (DUSC)
June 2016
Abstract
Purpose
To compare the predicted versus actual use of cabazitaxel, abiraterone and enzalutamide for metastatic castration resistant prostate cancer.
Date of listing on the Pharmaceutical Benefits Scheme (PBS)
- Cabazitaxel: 1 August 2012
- Abiraterone: 1 August 2013
- Enzalutamide: 1 December 2014
Data Source / methodology
Data was extracted from the Department of Human Services (DHS) prescription database for all PBS listings for the treatment of metastatic castration resistant prostate cancer and all PBS listings for docetaxel identified as being for the treatment of prostate cancer based on the date of supply to the patient. Data was extracted for the period January 2000 to March 2016, inclusive. Only records for males were included. The analyses include the number of prescriptions dispensed, number of patients treated, and the length of time on treatment. An assessment of therapies used prior to commencing cabazitaxel, abiraterone or enzalutamide was also undertaken.
Key Findings
- The total number of patients receiving a medicine subsidised for use in the post-docetaxel metastatic castration resistant prostate cancer (mCRPC) setting had increased substantially from 1,418 patients in 2013 to 4,165 patients in 2015. The number of patients treated was higher than predicted.
- The prescribing practices for these medicines is evolving. The therapy received by patients has changed when comparing patients who initiate a PBS listing for mCRPC in 2013 versus 2015. Not all of the patterns of use met the current PBS restrictions.
- When reviewing the therapies received for patients initiating treatment after the entry of enzalutamide to the market:
- around one-quarter (24%) of patients were first initiated on either abiraterone or enzalutamide without the prior use of docetaxel;
- around 10% of patients received a supply of cabazitaxel after abiraterone or enzalutamide; and
- 11% of patients transitioned from one oral drug to another (either abiraterone or enzalutamide).
Full Report
