Crohn’s disease: adalimumab and infliximab

Page last updated: 3 July 2015

Drug utilisation sub-committee (DUSC)

February 2015

Abstract

Purpose

To examine utilisation of biological disease-modifying anti-rheumatic drugs (bDMARDs) adalimumab and infliximab for Crohn’s disease. The analysis examined the use of these medicines for severe refractory Crohn’s disease and complex refractory fistulising Crohn’s disease in adult and paediatric patients.  The DUSC recalled that it had reviewed the utilisation of adalimumab for severe Crohn’s disease at its February 2011 meeting and adalimumab and infliximab for fistulising Crohn’s disease at its February 2013 meeting and requested an update to these analyses.

Date of listing on PBS

Infliximab was listed on the PBS for severe refractory Crohn’s disease in adult and paediatric patients (6-17 years) on 1 October 2007. It was listed for fistulising Crohn’s disease on 1 August 2010.

Adalimumab was listed for severe refractory Crohn’s disease in adult patients on 1 August 2008, and for fistulising Crohn’s disease on 1 April 2011.

Methods

The Department of Human Services (DHS) Authority Approvals database was used for the majority of analyses. The DHS Supplied Prescription database and DUSC Highly Specialised Drugs database were used for quantity supplied and expenditure analyses.

Key Findings

  • The number of patients using bDMARDs for severe refractory Crohn’s disease has increased progressively between 2007 and 2014 with over 5,000 patients receiving treatment in 2014.
  • Approximately 1,000 new patients start a bDMARD for severe refractory Crohn’s disease each year.
  • In 2014 1,345 patients received a bDMARD for fistulising Crohn’s disease and 394 patients received treatment for paediatric Crohn’s disease.
  • A much higher proportion of patients continue with bDMARD treatment than originally expected with that 91.7 %, 93.9 % and 91.5 % of patients receiving a second authority approval for adalimumab or infliximab for severe Crohn’s disease, fistulising Crohn’s disease and paediatric Crohn’s disease respectively.
  • In 2013, Government expenditure on bDMARDs for Crohn’s disease amounted to $103,840,325.

Full Report