Tyrosine kinase inhibitors for chronic myeloid leukaemia, October 2019

Page last updated: 6 March 2019

Drug utilisation sub-committee (DUSC)

October 2019

Abstract

Purpose

To analyse the utilisation of PBS-listed tyrosine kinase inhibitors (TKIs), imatinib, dasatinib, nilotinib and ponatinib, for the treatment of chronic myeloid leukaemia (CML), as requested by DUSC at its June 2019 meeting.

Date of listing on the Pharmaceutical Benefits Scheme (PBS)

For CML:

  • Imatinib: December 2001
  • Dasatinib: August 2007
  • Nilotinib: August 2008
  • Ponatinib: November 2015

Data Source / methodology

Data were extracted from the PBS supplied prescription database from the date of first listing of imatinib for CML (1 December 2001) to 31 March 2019. Authority approvals were extracted from the PBS authority approval database from November 2003 (the earliest time point of the database) to March 2019.

Key Findings

  • The number of prescriptions of imatinib, dasatinib, nilotinib and ponatinib supplied per year for CML had continued to grow since the previous analysis in 2014. Since the listing of imatinib in 2001, 6,179 patients initiated treatment for CML. In 2018, 437 patients initiated treatment, and 3,819 patients were treated.
  • The number of treated patients is growing in a linear manner, similar to the number of supplied prescriptions. The majority of this use was for patients in the chronic phase of disease being treated with their first line medicine. The second highest group is patients in the chronic phase of disease being treated with their second line medicine.
  • Imatinib was the most commonly used TKI for CML, however the use of nilotinib and dasatinib increased over the study period. Since 2016, the cost to government decreased due to price reductions. 
  • The use of ponatinib was small in the context of the CML market; 50 patients were treated with ponatinib in 2018.

Full Report