6 May 2019

Xeljanz rebate for PsA

Medications

Tofacitinib, sold under the brand name Xeljanz, will be listed on the Pharmaceutical Benefits Scheme (PBS) for the treatment of psoriatic arthritis.

Xeljanz, which is already available on the PBS for the treatment of rheumatoid arthritis, is expected to save psoriatic arthritis patients up to $16,000 per year.

The listing will allow patients to access the oral, targeted synthetic DMARD Xeljanz for about $40 per script, or under $7 as a concession card holder.

Associate Professor Andrew Östör, a consultant rheumatologist based in Melbourne, says it’s a major step forward in the management of psoriatic arthritis.

“This is very important because many patients do not gain sufficient control of their condition, both the skin and joint disease, with the currently available medications (traditional disease-modifying drugs and biologics),” he said.

But the medication, which is successful in blocking inflammation in joints, has also come under fire recently due to safety concerns.

A trial investigating cardiac health revealed that high doses (10mg twice a day) of Xeljanz increased the risk of blood clots in the lungs and death among rheumatoid arthritis patients.

Pfizer, the manufacturer of the drug, made the safety announcement after an undisclosed number of patients on higher doses experienced pulmonary embolism.

The Therapeutic Goods Administration (TGA) recently issued a safety alert reminding prescribers that a 10 mg twice daily dose was not approved for the treatment of rheumatoid arthritis in Australia.

However, the 10mg dose is approved in Australia for the initial short-term treatment of patients with ulcerative colitis.

Associate Professor Östör said rheumatologists should remain vigilant when prescribing but, at this stage, there is no cause for concern using Xeljanz to treat psoriatic arthritis.

“We have an effective overall safe oral therapy that shows very good responses in patients with psoriatic arthritis,” Associate Professor Östör said.