Goudarzi Mohaddeseh H, Eadie Mervyn J, Hollingworth Samantha A
School of Pharmacy, The University of Queensland, Australia.
School of Medicine, The University of Queensland, Australia.
Mult Scler Relat Disord. 2021 May;50:102835. doi: 10.1016/j.msard.2021.102835. Epub 2021 Feb 10.
New disease modifying therapies (DMT) to control relapsing-remitting multiple sclerosis (RRMS) have been introduced to the market in the past few years and are now widely used in Australia.
To analyse the dispensed use of government subsidised RRMS DMTs in Australia from 1996 to 2019.
We obtained data of dispensed use of DMTs from the Australian Government's Pharmaceutical Benefits Scheme (PBS) administered by Medicare Australia. We measured use as defined daily dose (DDD) per 100,000 population per day. We obtained jurisdictional population data from the Australian Bureau of Statistics.
Total DMT use increased by an average of 18% annually, from 2.4 (in 1996) to 69.9 DDD/100,000/day in 2019. Interferon β1B was the most commonly used medicine between 1996 and 2000, Interferon β1A between 2001 and 2014, and fingolimod subsequently. Among Australian states, Tasmania (the southernmost state) had the highest dispensed DMT use of 94.6 DDD/100,000/day in 2019. Concession beneficiaries under the Government's PBS had both lower use and cost per patient than general beneficiaries did. Fingolimod and ocrelizumab accounted for 55% of total expenditure on MS drug therapy in 2019.
The use of oral DMTs might increasingly replace parenteral treatments in the near future. Given the current substantial government expenditure on oral DMTs, it will be imperative to examine the real world effectiveness of DMTs.
在过去几年中，用于控制复发缓解型多发性硬化症（RRMS）的新型疾病修正疗法（DMT）已投放市场，目前在澳大利亚广泛使用。
分析1996年至2019年澳大利亚政府补贴的RRMS DMT的配药使用情况。
我们从澳大利亚医疗保险局管理的澳大利亚政府药品福利计划（PBS）中获取了DMT配药使用数据。我们将使用量衡量为每10万人每天的限定日剂量（DDD）。我们从澳大利亚统计局获得了各辖区的人口数据。
DMT的总使用量平均每年增长18%，从1996年的2.4（DDD/100,000/天）增至2019年的69.9 DDD/100,000/天。1996年至2000年最常用的药物是干扰素β1B，2001年至2014年是干扰素β1A，随后是芬戈莫德。在澳大利亚各州中，塔斯马尼亚州（最南端的州）2019年的DMT配药使用量最高，为94.6 DDD/100,000/天。政府PBS下的优惠受益人使用量和人均成本均低于普通受益人。2019年，芬戈莫德和奥瑞珠单抗占MS药物治疗总支出的55%。
在不久的将来，口服DMT的使用可能会越来越多地取代肠胃外治疗。鉴于目前政府在口服DMT上的大量支出，必须研究DMT在现实世界中的有效性。
