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Changes to the Australian Pharmaceutical Benefit Scheme restrictions for biological disease-modifying antirheumatic drugs have influenced the use of leflunomide

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dc.contributor.authorHopkins, A.
dc.contributor.authorVitry, A.
dc.contributor.authorO'Doherty, C.
dc.contributor.authorProudman, S.
dc.contributor.authorWiese, M.
dc.date.issued2017
dc.description.abstractIntroduction Methotrexate is the ‘anchor’ of rheumatoid arthritis (RA) treatment and leflunomide is commonly added in resistant disease, or where methotrexate is contraindicated.[1] In Australia, biological disease-modifying anti-rheumatic drugs (bDMARDs) are considered when response to conventional DMARD therapy is inadequate.[1, 2] They are expensive and criteria have been developed to restrict their use on the Australian Commonwealth Government subsidised Pharmaceutical Benefits Scheme (PBS). Prior to 2010, to qualify for bDMARDs, a patient must have been treated for at least 12 weeks with: (i) weekly methotrexate; (ii) combination therapy with methotrexate and at least two other DMARDs; and (iii) received treatment with leflunomide or cyclosporine.[2] In August 2010, these restrictions were modified so they could be accessed by patients who failed to respond to 6 months of therapy, which must include at least 3 months of methotrexate (unless contraindicated) and 3 months of hydroxychloroquine, leflunomide or sulfasalazine.[2] We aimed to assess the influence of these changes on the use and expenditure on leflunomide and bDMARDs.
dc.identifier.citationInternational Journal of Rheumatic Diseases, 2017; 20(11):1795-1797
dc.identifier.doi10.1111/1756-185X.12717
dc.identifier.issn1756-1841
dc.identifier.issn1756-185X
dc.identifier.orcidProudman, S. [0000-0002-3046-9884]
dc.identifier.urihttps://hdl.handle.net/11541.2/116573
dc.language.isoen
dc.publisherWiley Blackwell Publishing Asia
dc.rightsCopyright 2015 Asia Pacific League of Associations for Rheumatology and Wiley Publishing
dc.source.urihttps://doi.org/10.1111/1756-185X.12717
dc.subjectHumans
dc.subjectArthritis, Rheumatoid
dc.subjectAntirheumatic Agents
dc.subjectImmunosuppressive Agents
dc.subjectBiological Products
dc.subjectTreatment Outcome
dc.subjectProgram Evaluation
dc.subjectTime Factors
dc.subjectDrug Costs
dc.subjectHealth Expenditures
dc.subjectDrug Utilization Review
dc.subjectAustralia
dc.subjectPractice Patterns, Physicians'
dc.subjectClinical Decision-Making
dc.subjectLeflunomide
dc.titleChanges to the Australian Pharmaceutical Benefit Scheme restrictions for biological disease-modifying antirheumatic drugs have influenced the use of leflunomide
dc.typeJournal article
pubs.publication-statusPublished
ror.mmsid9916001111301831

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