Utilisation analysis of dasatinib and nilotinib for chronic myeloid leukaemia (CML)
Page last updated: 14 March 2025
Drug utilisation sub-committee (DUSC)
October 2024
Abstract
Purpose
The PBAC recommended that DUSC conduct a future review on the utilisation of dasatinib and nilotinib following a reduction in restriction levels to Authority Required (Telephone) for initial treatment and Authority Required (STREAMLINED) for first and subsequent continuing treatment which was implemented in March 2022.
Date of listing on the Pharmaceutical Benefits Scheme (PBS)
- Imatinib was first listed on the PBS for CML on 1st November 2003.
- Dasatinib was first listed on the PBS for CML on 1st August 2007.
- Nilotinib was first listed on the PBS for CML on 1st August 2008.
- Ponatinib was first listed on the PBS for CML on 1st November 2015.
Data Source / methodology
PBS dispensing data was extracted from the PBS data maintained by the Department of Health and Aged Care, processed by Services Australia.
Key Findings
- The utilisation of nilotinib and dasatinib has remained at a similar level following the restriction change in 2022 relative to utilisation prior to the change.
- The majority of patients start on imatinib before moving primarily to dasatinib and less to nilotinib. The number of patients supplied third and later line therapy are small with nilotinib more commonly supplied than dasatinib in later lines of therapy.
- Expenditure for 2023 was $79 million which has progressively decreased from a peak of approximately $138 million in 2015.
- Imatinib has resulted in a PBS expenditure of $1 billion for the CML indication since listing in 2003 followed by dasatinib at $543 million and nilotinib at $384 million.
- Imatinib expenditure as at 2023 was lower than dasatinib and nilotinib which represent the majority of the $79 million expenditure.
