Recent trends in pirfenidone and nintedanib utilisation for idiopathic pulmonary fibrosis in Australia

Background and Objectives: Idiopathic pulmonary fibrosis (IPF) is one of the most common forms of interstitial lung disease presenting in persons 50 years and older. There is currently no cure for IPF, but two medications (pirfenidone and nintedanib) have demonstrated the ability to slow functional decline of the lungs. In 2017, these two medications were listed on the Pharmaceutical Benefits Scheme (PBS) for subsidisation in Australia. Our study evaluates local trends in use of these two medications.

Methods: Prescription data for this analysis were obtained from the PBS Item Reports for the period May 2017-May 2020. Population data were extracted from the Australian Bureau of Statistics (ABS) data cubes. A descriptive approach was taken to conduct and report the analysis with the use of figures and graphs to illustrate trends in use of these two medications and associated costs.

Results: There were 44,010 prescriptions processed for the treatment for IPF in the 3-year period. Nintedanib use was higher than pirfenidone, accounting for 54% of prescriptions. NSW accounted for 35% of the total prescriptions, however when standardised to population size, ACT accounted for the highest proportion of prescriptions (24%). Prescriptions for nintedanib and pirfenidone were associated with a total cost of $131,377,951 over the period 2017-2020.

Conclusion: Our study provides initial information on prescription rates, practices, and expenditure for pirfenidone and nintedanib. Additionally, we provide some insight into possible pharmacological and epidemiological trends based on jurisdictional differences. Taken together, results from this study provide a platform for future research given the dearth of information on IPF in Australia.