Two different types of disease-modifying anti-rheumatic drugs (DMARDs) are used for the management of rheumatoid arthritis. These are referred to as conventional DMARDs and biologic DMARDs (bDMARDs). Since the introduction of bDMARDs in 2003, the government subsidy for DMARDs has increased markedly. This report examines the supply of, and increasing subsidy for, DMARDs through the Pharmaceutical Benefits Scheme (PBS) over a 5-year period, from 2003 to 2007.

What was the financial cost of DMARD treatment through the PBS?

  • DMARDs supplied through the PBS cost $472 million over the 2003 to 2007 period. The annual cost increased three fold to $134 million over this time.
  • Almost 84% of the expense for conventional DMARDs was paid for by the Australian Government under the PBS during the 5-year period. However, the proportion of the cost met by the patient increased from 13% in 2003 to 20% in 2007.
  • During the 5-year period, bDMARD treatment cost $243 million; more than one-half of the total cost for all DMARDs. bDMARDs accounted for only 4% of DMARD prescription volume.

What DMARDs were supplied?

  • More than 3.4 million DMARD prescriptions were subsidised by the PBS for the treatment of rheumatoid arthritis from 2003 to 2007.
  • Conventional DMARDs accounted for 96% of all DMARDs supplied through the PBS, with bDMARDs accounting for the remaining 4%.

Who was supplied with DMARDs?

  • Approximately 236,000 Australians were supplied with at least one conventional DMARD through the PBS during the 5-year period. Only 7,298 Australians received bDMARDs.
  • Patients in the 55–64 years age group were the largest group of people receiving DMARDs.
  • Almost two-thirds of those who received conventional DMARDs were females; a similar but slightly higher proportion of those who received bDMARDs were females.

Who were the DMARD prescribers?

  • Almost three quarters of conventional DMARD scripts were written by general practitioners (GPs) and other primary care medical practitioners (OMPs).
  • Only rheumatologists and clinical immunologists are authorised to prescribe bDMARDs.

Does starting treatment with bDMARDs change the supply of conventional DMARDs?

  • Nine out of 10 people were supplied conventional DMARDs for the management of their rheumatoid arthritis in the 12 months prior to starting bDMARD treatment. The proportion reduced to three out of four people in the year following the start of bDMARDs.
  • Supply of all conventional DMARDs, except methotrexate, decreased after the initiation of bDMARD treatment.