Biologics for uncontrolled severe allergic and eosinophilic asthma, October 2019
Page last updated: 6 March 2020
Drug utilisation sub-committee (DUSC)
October 2019
Abstract
Purpose
DUSC requested a review of biologics for uncontrolled severe asthma when 24 months of data were available since the listing of mepolizumab. When DUSC last considered omalizumab for review (September 2017), it decided to delay further review of omalizumab until sufficient mepolizumab data were available.
Following publication of the outcomes from the severe asthma stakeholder meeting, DUSC considered it timely to consider the use of biologics for the treatment of uncontrolled severe asthma.
Date of listing on the Pharmaceutical Benefits Scheme (PBS)
- Omalizumab: 1 July 2011
- Mepolizumab: 1 January 2017
- Benralizumab: 1 December 2018
Data Source / methodology
Data were extracted from the PBS supplied prescription database from the date of first listing of a severe asthma biologic (1 July 2011) to 30 June 2019. Analyses included prescription counts, new and prevalent patient counts, treatment sequence, switching, length of treatment and prescriber type. A predicted versus actual analysis of mepolizumab in the first 24 months of listing was also conducted.
Key Findings
- In 2018,
- 1,250 patients were supplied omalizumab for the treatment of severe allergic asthma. Of these, 444 received their first PBS supply in that year.
- 1,222 patients received PBS-subsidised treatment for severe eosinophilic asthma, of which 665 were new to treatment that year.
- The number of prescriptions supplied for severe asthma biologics was over 24,000. There were 14,620 prescriptions dispensed for omalizumab and 9,415 prescriptions dispensed for mepolizumab. A small number of prescriptions were dispensed for benralizumab (listed December 2018).
- expenditure for severe asthma biologics was $31.3 million based on the published prices (special pricing arrangements apply). This expenditure was mostly attributed to omalizumab and mepolizumab in close to a 1:1 ratio, with little expenditure for benralizumab (listed 1 December 2018).
- There has been a high rate of growth in the number of treated prevalent severe eosinophilic asthma patients since the listing of mepolizumab, with the rate of growth further increasing with the listing of benralizumab in December 2018. These patients exceeded the number of patients supplied omalizumab for severe allergic asthma in the first half of 2019.
- In quarter 2 of 2019, prescriptions dispensed for eosinophilic asthma exceeded prescriptions dispensed for allergic asthma for the first time.
- Use of mepolizumab was higher than predicted in the first two years of PBS listing
