Snapshot of rheumatology drug use

A report on the dispensing of DMARDs, bDMARDs and NSAIDs in three rheumatological conditions has painted a picture of medication use in these patient groups and the cost of managing the disease.

The AIHW report using PBS data from the 2016-17 year found more than 81,500 prescriptions for bDMARDs specific to the treatment of ankylosing spondylitis were dispensed.

Adalimumab (44%) was the most commonly prescribed biologic, followed by etanercept (21%) and golimumab (20%) at a total cost of about $124.6 million for all biologics.

Of the 9,000 patients dispensed bDMARDs, most (65%) were male and most were in the 40-49 year age group.

For psoriatic arthritis, more than 141,000 prescriptions were dispensed – mostly leflunomide (45%), adalimumab (23%) and etanercept (11%).

About $120.3 million was spent on medications for the disease for more than 22,100 patients. The most expensive drugs were adalimumab, etanercept and golimumab.

“Interestingly, leflunomide had the lowest benefits paid, but the highest proportion of all prescriptions supplied for psoriatic arthritis (45%),” the AIHW report said.

It found psoriatic arthritis was more common in females (62%) and in those aged 50–69.

The AIHW report also found over 2,100 PBS-listed medications were prescribed by rheumatologists to children for juvenile arthritis.

“The 5 most commonly prescribed medications (adalimumab, methotrexate, naproxen, etanercept and piroxicam, respectively) accounted for almost half (42%) of all rheumatologist-prescribed medications.”

The report said it was difficult to estimate the prevalence of juvenile arthritis because it was so uncommon.

While the number of children being dispensed NSAIDs or DMARDs resulted in a count of 5,395 children, this is likely to be an underestimate of the true prevalence of juvenile arthritis because lower-dose, over-the-counter NSAIDs such as ibuprofen were not included in the PBS data set.

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