Abstract
Background Ofatumumab is a self-administered disease modifying therapy (DMT) approved in Australia for relapsing multiple sclerosis (RMS). We have previously described a novel, high efficacy therapy (HET) classification system1 which includes ofatumumab and other monoclonal antibody therapies, ocrelizumab, natalizumab and alemtuzumab. Given the reimbursement of ofatumumab in October 2021, and in the context of this proposed classification system, we analysed the utilisation of these HETs for multiple sclerosis (MS) in Australia.
Methods DMT utilisation was analysed using an unbiased 10% sample of the Pharmaceutical Benefits Scheme Claims database as supplied by Services Australia. Patients-on-therapy (PoT) counts were attributed to the most recently prescribed DMT whilst initiations were defined as the first time a patient was prescribed a new DMT (treatment-naïve and switch) during a specified time-period.
Results From September, 2021 (pre-ofatumumab reimbursement) to October, 2023, PoT for any DMT rose by 10.4% (23,070-to-25,460). In the same period, HET PoT rose by 31.3% (9,830-to-12,910), driven by increases in ofatumumab (+2,010), ocrelizumab (+1,050), and natalizumab (+110). By contrast, non-HET PoT fell by 5.2% (13,240-to-12,550), driven by fingolimod (-1,020) and dimethyl fumarate (-530). In the 12 months prior to ofatumumab reimbursement, 46.7% (2,200/4,710) of DMT initiations were HET but this proportion rose to 53.1% (2,920/5,500) in the most recent 12 month period (November-October 2023), driven by ofatumumab (1,200; 21.8%), ocrelizumab (1,090; 19.8%), and natalizumab (730; 11.5%).
Conclusions The availability of a self-administered, at-home HET option in ofatumumab has correlated with an expansion of HET utilisation in Australia.
Reference
Butzkueven, et al. P755. ECTRIMS-ACTRIMS 2023.
