bDMARDs for severe chronic plaque psoriasis: analysis of utilisation
Drug utilisation sub-committee (DUSC)
To examine the utilisation of the biological disease-modifying anti-rheumatic drugs (bDMARDs) adalimumab, etanercept, infliximab and ustekinumab for the treatment of severe chronic plaque psoriasis on the Pharmaceutical Benefits Scheme (PBS).
The Pharmaceutical Benefits Advisory Committee (PBAC) requested the DUSC examine utilisation of bDMARDs for the treatment of severe chronic plaque psoriasis at its July 2012 meeting. At its March 2013 meeting in consideration of adalimumab for moderate to severe plaque psoriasis, the PBAC noted there may be a proportion of patients with moderate psoriasis who are receiving PBS subsidised treatment under the restriction for severe psoriasis. This utilisation analysis examined the utilisation of all bDMARDs listed for severe chronic plaque psoriasis in adults. An overview of etanercept utilisation in patients less than 18 years is presented in Appendix 1.
Data Source / methodology
The Department of Human Services (DHS) Medicare Authority Approvals database was used for the majority of analyses. The DHS Medicare Supplied Prescription database and Highly Specialised Drugs database were used for quantity supplied and expenditure analyses.
- The number of patients using bDMARDs for psoriasis has increased progressively between 2006 and 2013.
- Approximately 500 new patients have started treatment each year since 2006.
- Close to 3,500 patients received an Authority approval for a bDMARD for psoriasis in 2013.
- Treatment continuation is high with 86% of patients receiving a fourth Authority approval for a bDMARD.
- Ustekinumab is the most commonly used bDMARD, followed by adalimumab.