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Ten years of publicly funded biological disease-modifying antirheumatic drugs in Australia

Ashley M Hopkins, Susanna M Proudman, Agnes I Vitry, Michael J Sorich, Leslie G Cleland and Michael D Wiese
Med J Aust 2016; 204 (2): 64-68. || doi: 10.5694/mja15.00716
Published online: 1 February 2016

Summary

  • Biological disease-modifying antirheumatic drugs (bDMARDs) for rheumatoid arthritis (RA) treatment were among the first high-cost medicines to be subsidised in Australia.
  • High-cost medicines pose several challenges to the Australian National Medicines Policy, which aims to provide timely access to effective medicines at a cost individuals and the community can afford. Thus, novel restriction criteria were developed to encourage cost-effective use of bDMARDs.
  • Government expenditure on bDMARD subsidies for RA treatment grew to about $383 million in 2014.
  • Evidence that initiation and continuation criteria for bDMARDs meet usually applied cost–benefit criteria is lacking.
  • The combined expenditure on tocilizumab, certolizumab pegol and golimumab (added to the Australian Government’s Pharmaceutical Benefits Scheme in 2010) was $93 million in 2014, which is 210% over the initial estimate.
  • Present and future challenges with regard to bDMARDs for RA and other high-cost drugs include improved expenditure predictions, monitoring of cost-effectiveness in relation to actual use and strategic development, regulation and use of biosimilars.
  • Ten years of documentation on clinical and laboratory findings indicating eligibility to initiate and continue on bDMARDs remains un-used. These data represent an untapped opportunity to promote quality of use of bDMARDs and biosimilars and to improve cost predictions for high-cost drugs.

  • Ashley M Hopkins1
  • Susanna M Proudman2,3
  • Agnes I Vitry1
  • Michael J Sorich4
  • Leslie G Cleland2,3
  • Michael D Wiese1

  • 1 University of South Australia, Adelaide, SA
  • 2 University of Adelaide, Adelaide, SA
  • 3 Royal Adelaide Hospital, Adelaide, SA
  • 4 Flinders University, Adelaide, SA


Competing interests:

No relevant disclosures.

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