Antifungals for systemic use
Page last updated: 3 March 2017
Drug utilisation sub-committee (DUSC)
September 2016
Abstract
Purpose
The analysis examined the utilisation of antifungal medicines for systemic use. This includes a predicted versus actual analysis of the voriconazole listing for prophylaxis against invasive fungal infections in certain high risk patients.
Date of listing on the Pharmaceutical Benefits Scheme (PBS)
The systemic antifungal medicines currently listed on the PBS are: fluconazole, itraconazole, posaconazole, voriconazole, terbinafine and griseofulvin. There have been a number of changes to the PBS listings for systemic antifungals since the last DUSC analysis in October 2013. Ketoconazole was removed from the Australian market in December 2013. Voriconazole was listed for prophylaxis against invasive fungal infections in December 2014. Posaconazole tablets were listed on 1 September 2015. Fluconazole and itraconazole became Restricted Benefit listings in April 2016.
Data Source / methodology
The analyses use data from the DUSC database, the Department of Human Services (DHS) Medicare Supplied prescriptions database and the DHS Authority approvals database from January 2008 to July 2016. Telephone and streamlined authority medicines were matched to their authority approvals to identify the restriction for use.
Key Findings
- In the 2015-16 financial year, 91,874 people received systemic antifungal medicines on the R/PBS. There were 203,228 prescriptions supplied at cost of $35,564,069 to the R/PBS.
- Terbinafine and griseofulvin were the most widely used medicines with over 30,000 people supplied each of the medicines in the 2015 16 financial year.
- Terbinafine had remained the most utilised antifungal in terms of the prescriptions supplied since 2008. The number of fluconazole, itraconazole and posaconazole prescriptions had continued to increase. The number of voriconazole prescriptions had decreased after peaking in 2012. The number of griseofulvin prescriptions had remained relatively stable since 2012.
- Posaconazole had the highest PBS expenditure, costing $18,347,465 in the 2015-16 financial year.
- There had been a sharp increase in the use of fluconazole since it changed to a Restricted Benefit from 1 April 2016. This may have been due to use for vulvovaginal candidiasis and dermatophyte infections.
