bDMARDs for psoriatic arthritis, February 2016

Page last updated: 8 July 2016

Drug utilisation sub-committee (DUSC)

February 2016



To assess the utilisation of disease modifying anti-rheumatic drugs (DMARD) prior to initiation of biological DMARDs (bDMARDs) for psoriatic arthritis.  

Date of listing on the Pharmaceutical Benefits Scheme (PBS) for this indication

  • Adalimumab: 1 August 2006
  • Etanercept: 1 August 2006
  • Infliximab: 1 August 2006
  • Golimumab: 1 August 2010
  • Certolizumab pegol: 1 April 2015

Data Source / methodology

The DHS prescription claims database was used for the analyses in this addendum.

Key Findings

  • Approximately 17% of patients may not have trialled methotrexate and sulfasalazine or leflunomide prior to their first bDMARD in accordance with the PBS restriction. Patients with a contraindication are exempt from this requirement for the relevant medicine.
  • The proportion of patients trialling none of the restriction specified drugs (methotrexate, sulfasalazine and leflunomide) may be slowly increasing (see Figure 1).
  • At initiation to bDMARD therapy for psoriatic arthritis, 35% of patients added the bDMARD to an existing DMARD regimen, 52% of patients substituted one or more drugs in an existing DMARD regimen and 13% initiated without having been on any DMARD at the time.
  • At initiation 40% of patients were on bDMARD monotherapy and 60% were using a combination of DMARD and bDMARD. Twelve months after initiation 42% of patients were on bDMARD monotherapy and 58% were using a combination of DMARD and bDMARD.

Full Report