IL-17A inhibitor listed on the PBS for ankylosing spondylitis

The PBS listing for ixekizumab (Taltz) has been extended to include adult patients with active ankylosing spondylitis (AS).

Ixekizumab was already available on the PBS for severe psoriatic arthritis and severe chronic plaque psoriasis.

The PBAC’s decision to recommend the new PBS listing was made largely on the basis of evidence from the COAST and MEASURE studies.

The COAST-V and COAST-W studies compared ixekizumab with adalimumab and placebo in biological medicine-naïve patients with AS.

And there was an indirect treatment comparison using a meta-analysis of the COAST studies versus a meta-analysis of MEASURE 2 and 4 which had compared secukinumab with placebo.

“The PBAC considered that the claim that ixekizumab is non-inferior to adalimumab and secukinumab in terms of comparative effectiveness and safety was reasonable,” their Public Summary Document said.

The Committee noted the availability of six alternative therapies for the treatment of AS and that clinical need for an additional treatment was therefore low.

However “…the addition of another option may be useful for some patients,” the PBAC said.

“The PBAC recommended the listing of ixekizumab on a cost-minimisation basis to the least costly biological medicine for ankylosing spondylitis (AS). In making this recommendation, the PBAC accepted any of the current PBS listed biological medicines for AS could be an alternative therapy to ixekizumab.”

The PBAC said no evidence had been provided in the submission demonstrating superiority of ixekizumab against any of the other alternative therapies

Federal Minister for Health Greg Hunt said in a media statement that up to 8,000 patients would benefit from the PBS listing of ixekizumab for AS.

“Thousands of Australians with debilitating back and joint pain will have access to a life changing treatment option through the Pharmaceutical Benefits Scheme (PBS) which would otherwise cost tens of thousands of dollars,” he said.

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