The Drug Utilisation Sub-Committee (DUSC) of the Pharmaceutical Benefits Advisory Committee (PBAC) held its 111th meeting. The DUSC focuses on collecting, analyzing, and interpreting data on the utilization of medicines in Australia, which is vital for achieving the objectives of the National Medicines Policy. This ensures that the Pharmaceutical Benefits Scheme (PBS) listings are evidence-based and effectively managed. The PBAC is also committed to integrating consumer perspectives into its consideration of medicines and vaccines.
Consumers can provide their views about medicine utilization reviews through the Office of Health Technology Assessment (OHTA) consultation hub, ensuring that patient experiences and needs are considered in the decision-making process. DUSC noted the receipt of nine category 1, twelve category 2, two standard re-entry, and three early re-entry submissions for the upcoming July 2024 PBAC meeting. Detailed advice was provided to the PBAC on projected usage and financial cost for submissions with high cost, uncertain utilization, first medicine in class, or quality use of medicines concerns. The agenda for the July 2024 PBAC meeting is available on the PBS website.
DUSC regularly examines the utilization of PBS items when there is at least 24 months of prescription data available, and where DUSC or PBAC has highlighted items of interest. Sponsors are notified and provided with a copy of the report and an opportunity to comment prior to the DUSC meeting. Reviews to be considered by the PBAC are published in the PBAC meeting agenda. All reports, sponsor comments, and DUSC assessments are subsequently provided to the PBAC.
Utilization of PBS Listed Medicines
DUSC reviewed the utilization of brentuximab vedotin for CD30 positive cutaneous (CTCL) and peripheral (PTCL) T-cell lymphoma. 36 patients received 207 prescriptions for CD30 positive CTCL, and 113 patients received 428 prescriptions for CD30 positive PTCL. Utilization for CD30 positive PTCL had increased over time. DUSC requested that the report be provided to the PBAC for consideration. The utilization of galcanezumab and fremanezumab for chronic migraine since their listing on the PBS in June and August 2021, respectively, was reviewed. Analyses included co-prescribing with analgesics and other migraine medicines, as well as geospatial analyses of supply through specialty migraine clinics.
While the utilization of galcanezumab differed from initial predictions, fremanezumab’s utilization was comparable to expectations. Â DUSC noted that some patients were co-dispensed analgesics and first-line prophylaxis medications with their migraine treatments. Â The geographic pattern of dispensing did not match the provision of Botulinum toxin type A (Botox) services under the Medicare Benefits Schedule. DUSC requested that the report be provided to the PBAC for consideration.
DUSC reviewed the utilization of semaglutide for type 2 diabetes mellitus (T2DM). In 2023, approximately 1.6 million patients were supplied with one or more medicines for T2DM through the PBS, with 325,993 patients receiving semaglutide or dulaglutide, and 120,374 initiators to these medications. Among these initiators DUSC requested that the report be provided to the PBAC for further consideration. The assessment of semaglutide usage is essential due to its significant role in managing type 2 diabetes mellitus and the impact of shortages on patient care. Ensuring adequate supply and understanding usage patterns will aid in optimizing treatment strategies.
Future Utilization Analysis of PBS Listed Medicines
The utilization of the following medicines has been selected for consideration at future DUSC meetings. These analyses aim to provide comprehensive insights into the effectiveness and safety of these treatments, ensuring that PBS listings reflect the best available evidence: Dasatinib and Nilotinib for Chronic Myeloid Leukaemia Both dasatinib and nilotinib are used to treat chronic myeloid leukaemia (CML). The analysis will focus on their usage patterns, safety profiles, and effectiveness in managing CML over time. This evaluation is crucial for ensuring optimal treatment options for patients with CML.
Idelalisib for Refractory Follicular B-cell Non-Hodgkin Lymphoma Idelalisib, used for treating refractory follicular B-cell non-Hodgkin lymphoma, will be evaluated to understand its utilization, safety, and effectiveness. This analysis will help determine the best approach for managing this challenging condition. Molnupiravir for SARS-CoV-2 Infection Molnupiravir, an antiviral medication for treating SARS-CoV-2 infection, will be reviewed to assess its real-world usage, effectiveness, and safety. This analysis will provide valuable insights into its role in managing COVID-19 and its impact on public health.
The Drug Utilisation Sub-Committee (DUSC) plays a vital role in ensuring the effective management of the Pharmaceutical Benefits Scheme (PBS) by systematically reviewing the utilization of medicines in Australia. By providing detailed assessments and integrating consumer perspectives, DUSC helps the Pharmaceutical Benefits Advisory Committee (PBAC) make informed decisions about medicine listings. The recent reviews of brentuximab vedotin, galcanezumab, fremanezumab, and semaglutide highlight the importance of continuous evaluation to optimize healthcare outcomes. Future analyses of dasatinib, nilotinib, idelalisib, and molnupiravir will further contribute to ensuring that the PBS remains responsive to the evolving needs of patients and healthcare providers.
Resource: The Pharmaceutical Benefits Scheme, July 19, 2024
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