Rheumatoid arthritis Practice Review – Accessible version of data in this report

Fig. 2 – Types of csDMARDs dispensed before starting a b/tsDMARD for RA

Percentage of patients starting b/tsDMARD treatment for RA (1 Jan 2018 to 31 Dec 2019)

National

NSW/ACT

VIC/TAS

QLD

NT/SA

WA

MTX

87

87

88

86

84

84

Leflunomide

34

36

28

37

36

42

Sulfasalazine

30

32

29

35

37

20

Hydroxychloroquine

56

52

60

61

61

47

Fig. 3 – Types of MTX dispensed before starting b/tsDMARD for RA in 2017, 2018 or 2019

Percentage of patients starting b/tsDMARD treatment for RA (by year)

National

2017

2018

2019

Oral MTX only

47

50

38

Subcutaneous MTX only

12

18

15

Oral and subcutaneous MTX

24

21

38

No MTX

18

11

9

NSW/ACT

2017

2018

2019

Oral MTX only

78

81

82

Subcutaneous MTX only

2

1

1

Oral and subcutaneous MTX

4

4

5

No MTX

17

14

12

VIC/TAS

2017

2018

2019

Oral MTX only

77

80

79

Subcutaneous MTX only

3

3

2

Oral and subcutaneous MTX

5

5

7

No MTX

15

12

12

QLD

2017

2018

2019

Oral MTX only

76

80

73

Subcutaneous MTX only

3

2

2

Oral and subcutaneous MTX

4

5

11

No MTX

18

13

14

NT/SA

2017

2018

2019

Oral MTX only

69

71

70

Subcutaneous MTX only

4

3

4

Oral and subcutaneous MTX

6

9

12

No MTX

20

18

15

WA

2017

2018

2019

Oral MTX only

80

75

77

Subcutaneous MTX only

3

3

2

Oral and subcutaneous MTX

3

4

6

No MTX

14

18

14

Fig. 4 – Choice of first-line b/tsDMARD treatment for patients with RA

Percentage of patients starting b/tsDMARD treatment for RA (1 Jan 2018 to 31 Dec 2019)

National

NSW/ACT

VIC/TAS

QLD

NT/SA

WA

Adalimumab

24

25

25

21

26

21

Certolizumab

5

5

6

4

4

3

Etanercept

19

19

23

18

15

15

Golimumab

16

16

12

20

15

21

Infliximab

0

0

0

0

0

0

Baricitinib

9

7

11

9

7

8

Tofacitinib

16

16

12

17

21

23

Rituximab

1

1

1

1

1

1

Abatacept

4

4

5

4

5

3

Tocilizumab

6

7

5

6

7

4

Fig. 5 – Number of unique patients dispensed prescriptions for b/tsDMARDs for RA over the years

National

2016

2017

2018

2019

TNF inhibitor

Adalimumab

7681

8149

8580

8635

Certolizumab

1416

1435

1744

2020

Etanercept

6484

6724

7125

7018

Golimumab

655

719

2151

2863

Infliximab

325

318

305

296

JAK inhibitor

Baricitinib

0

0

875

3485

Tofacitinib

3417

4415

5619

6211

B lymphocyte modulator

Rituximab

1114

1201

1184

1158

T lymphocyte modulator

Abatacept

3462

3290

2806

3274

IL-6 inhibitor

Tocilizumab

3302

4494

5132

5415

NSW/ACT

2016

2017

2018

2019

TNF inhibitor

Adalimumab

2406

2573

2739

2782

Certolizumab

443

458

555

684

Etanercept

2319

2374

2452

2352

Golimumab

204

219

623

849

Infliximab

98

87

85

84

JAK inhibitor

Baricitinib

0

0

215

957

Tofacitinib

1079

1357

1736

1980

B lymphocyte modulator

Rituximab

267

300

283

273

T lymphocyte modulator

Abatacept

1030

987

798

984

IL-6 inhibitor

Tocilizumab

1002

1424

1688

1797

VIC/TAS

2016

2017

2018

2019

TNF inhibitor

Adalimumab

2436

2686

2827

2865

Certolizumab

465

508

632

729

Etanercept

1632

1826

2117

2185

Golimumab

162

184

533

741

Infliximab

79

87

73

72

JAK inhibitor

Baricitinib

0

0

347

1390

Tofacitinib

1142

1500

1785

1780

B lymphocyte modulator

Rituximab

368

417

384

389

T lymphocyte modulator

Abatacept

943

910

839

1019

IL-6 inhibitor

Tocilizumab

930

1268

1432

1532

QLD

2016

2017

2018

2019

TNF inhibitor

Adalimumab

1208

1222

1324

1312

Certolizumab

289

254

290

317

Etanercept

1004

1042

1089

1090

Golimumab

156

165

500

627

Infliximab

54

63

70

70

JAK inhibitor

Baricitinib

0

0

155

502

Tofacitinib

682

863

1019

1096

B lymphocyte modulator

Rituximab

221

231

247

263

T lymphocyte modulator

Abatacept

586

567

468

531

IL-6 inhibitor

Tocilizumab

620

812

944

1028

NT/SA

2016

2017

2018

2019

TNF inhibitor

Adalimumab

577

620

653

655

Certolizumab

55

55

73

104

Etanercept

485

473

473

479

Golimumab

51

67

178

202

Infliximab

22

30

30

28

JAK inhibitor

Baricitinib

0

0

31

210

Tofacitinib

221

324

435

506

B lymphocyte modulator

Rituximab

67

73

69

66

T lymphocyte modulator

Abatacept

259

275

251

278

IL-6 inhibitor

Tocilizumab

268

376

438

422

WA

2016

2017

2018

2019

TNF inhibitor

Adalimumab

1115

1106

1111

1073

Certolizumab

171

170

199

193

Etanercept

1072

1042

1019

941

Golimumab

82

87

322

457

Infliximab

72

51

48

43

JAK inhibitor

Baricitinib

0

0

127

427

Tofacitinib

301

390

665

875

B lymphocyte modulator

Rituximab

193

183

201

172

T lymphocyte modulator

Abatacept

654

570

458

471

IL-6 inhibitor

Tocilizumab

498

640

661

666

Fig. 6 – Prescribing of glucocorticoids ≥ 6 months after starting b/tsDMARD treatment for RA

Percentage of patients who started b/tsDMARD treatment (1 Nov 2016 to 31 Oct 2018)

National

NSW/ACT

VIC/TAS

QLD

NT/SA

WA

0 prescriptions

50

52

43

53

58

55

1-2 prescriptions

18

17

18

18

18

18

3-4 prescriptions

7

7

8

7

7

9

≥ 5 prescriptions

25

24

31

23

18

17

Fig. 7 – Prescribing of opioids for patients also prescribed b/tsDMARDs for RA

Percentage of patients dispensed b/tsDMARDs (1 Jan 2018 to 31 Dec 2019)

National

NSW/ACT

VIC/TAS

QLD

NT/SA

WA

0 prescriptions

53

56

53

49

48

52

1-5 prescriptions

26

25

26

27

29

26

6-9 prescriptions

5

4

4

5

6

5

≥ 10 prescriptions

16

14

17

19

17

17

Return to the PBS Practice Review – Rheumatoid arthritis: Quality use of b/tsDMARDs and other medicines