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

Ashley M. Hopkins, Agnès Isabelle Vitry, Catherine E. O'Doherty, Susanna M. Proudman, Michael D. Wiese

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Dear Editor,
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.
Original languageEnglish
Pages (from-to)1795-1797
Number of pages3
JournalInternational Journal of Rheumatic Diseases
Volume20
Issue number11
DOIs
Publication statusPublished - 1 Nov 2017
Externally publishedYes

Keywords

  • Rheumatoid arthritis
  • Pharmaceutical Benefits Scheme (PBS)
  • leflunomide

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