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089 Clinical variation in the use of disease-modifying therapies for multiple sclerosis between different states and territories in Australia, 2019–20
  1. Kieren Po1,2 and
  2. Michael H Barnett2,3
  1. 1Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
  2. 2Department of Neurology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
  3. 3Brain and Mind Centre, The University of Sydney, Camperdown, NSW, Australia


Objectives In Australia, patient costs for multiple sclerosis disease-modifying therapies (DMTs) are government-subsidised under the Pharmaceutical Benefits Scheme (PBS). Unlike many countries, any DMT can be selected for a patient who fulfils treatment criteria. We aimed to determine whether clinical variation exists in the use of DMTs in different Australian states and territories.

Methods DMT usage was determined from PBS prescription dispensing statistics for all DMTs available in Australia from July 2019 to June 2020.1 Pa

Results There were 176,163 prescriptions for DMTs dispensed for an estimated 18,596 patients, with a total drug cost of AU$344.1 million and mean drug cost per patient of AU$18,501. Most patients were treated with oral (41.7%) or infusion (33.8%) maintenance DMTs. Fewer received platform injectable DMTs (15.3%) or immune reconstitution DMTs (9.1%) in the study period. The most common DMTs were fingolimod (23.5%), ocrelizumab (21.8%), natalizumab (12.1%), and dimethyl fumarate (10.8%). Platform injectable DMTs were most common in ACT (20.1%) and least common in Victoria (13.0%). Oral DMTs were most common in NSW (44.0%) and least common in Tasmania (29.3%). Infusion DMTs were most common in Tasmania (47.4%) and least common in ACT (27.7%).

Conclusion We have demonstrated marked variation in DMT use in different Australian states and territories during the study period. The use of DMTs in Australia has evolved over time,3 but differences between states/territories remain unexplained. We plan to investigate the observed clinical variation in future studies.


  1. Department of Health. Pharmaceutical Benefits Scheme. Canberra: Australian Government; 2021. 19 Feb 2021).

  2. WHO Collaborating Centre for Drug Statistics Methodology. ATC-DDD Toolkit: Defined Daily Dose (DDD). Geneva: World Health Organization; 2021. (accessed 19 Feb 2021).

  3. Goudarzi MH, et al. Disease modifying therapies for relapsing-remitting multiple sclerosis: use and costs in Australia (1996-2019). Mult Scler Relat Disord 2021;50:102835.

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