Changes to the Australian Pharmaceutical Benefit Scheme restrictions for biological disease-modifying antirheumatic drugs have influenced the use of leflunomide
التفاصيل البيبلوغرافية
العنوان:
Changes to the Australian Pharmaceutical Benefit Scheme restrictions for biological disease-modifying antirheumatic drugs have influenced the use of leflunomide
Introduction 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.
