PBS Update 2015-16

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PBS Spending The changing composition of the PBS PBS ‘Top 10’ drugs Shifting sands for industry The under co-payment market and formularies

PBS Update 2015-16

Reimbursement of the new hepatitis C therapies contributed to a dramatic growth in PBS spending even allowing for ’revenue’ from the payment of rebates 19.3% 16.2%

9.2%

9.4%

9.1%

9.2%

9.0% 5.2% 3.2%

6.1%

1.9%

4.3%

-4.5%

-3.5%

02-03 03-04 04-05 05-06 06-07 07-08 08-09 09-10 10-11 11-12 12-13 13-14 14-15 15-16 Source: PBS Statistics, Department of Health (including revenue)

PBS Spending Growth across all categories PBS ‘Top 10’ drugs Shifting sands for industry The under co-payment market and formularies

Year-on-year growth across all PBS categories Growth by category – 14-15 to 15-16 $1,645m

$788m $569m $407m

$374m $150m

Concessional

General

HSD*

S100

Revenue

Total

2014-15

$5,383m

$1,505m

$1,209m

$2,155m

$574m

$8,498m

2015-16

$6,172m

$1,912m

$1,583m

$2,724m

$724m

$10,143m

Source: PBS Statistics, Department of Health (Section 85 only) *HSD included in S100

PBS Spending Growth across all categories PBS ‘Top 10’ drugs Shifting sands for industry The under co-payment market and formularies

In 2015-16, the hepatitis C therapies listed just four months before the end of the year had an immediate impact on shaping PBS spending Drug

Brand

Treats

Govt Cost 14-15

Drug

Brand

Treats

Govt Cost 15-16

Adalimumab

HUMIRA

Rheumatoid arthritis

$312m

Ledipasvir/ Sofosbuvir

HARVONI

Hepatitis C

$357m

Rosuvastatin

generic

Cholesterol

$215m

Adalimumab

HUMIRA

$334m

Fluticasone/ Salmeterol

SERETIDE

Asthma

$177m

Rheumatoid arthritis

Ranibizumab

LUCENTIS

Macular degeneration

$217m

Aflibercept

EYLEA

Macular degeneration

$174m

Sofosbuvir

SOVALDI

Hepatitis C

$213m

Esomeprazol e

generic

Reflux

$174m

Aflibercept

EYLEA

Macular degeneration

$213m

Etanercept

ENBREL

Rheumatoid arthritis

$163m

Esomeprazole

generic

Reflux

$166m

Ranibizumab

LUCENTIS

Macular degeneration

$157m

Etanercept

ENBREL

Rheumatoid arthritis

$164m

Insulin glargine

LANTUS

Diabetes

$144m

Fluticasone/ Salmeterol

SERETIDE

Asthma

$148m

Fingolimod

GILENYA

Multiple sclerosis

$138m

Fingolimod

GILENYA

Multiple sclerosis

$147m

Atorvastatin

generic

Cholesterol

$123m

Insulin glargine

LANTUS

Diabetes

$146m

$1,777m

TOTALS

TOTALS

Source: PBS Statistics, Department of Health (Section 85 only) rebates not factored

$2,105m

New products and extended listings dominated contributors to growth Change in Government cost – 14-15 to 15-16 Ledipasvir/Sofosbuvir (HARVONI) Sofosbuvir (SOVALDI)

$357m $213m

Hepatitis C Hepatitis C

Daclatasvir (DAKLINZA)

$79m

Hepatitis C

Ranibizumab (LUCENTIS)

$60m

Eye therapy

Enzalutamide (XTANDI)

$38m

Cancer

Aflibercept (EYLEA)

$38m

Eye therapy

Trametinib (MEKINIST)

$37m

Cancer

Apixaban (ELIQUIS)

$29m

Atrial fibrillation

Denosumab (PROLIA/XGEVA)

$28m

Bone therapy

Source: PBS Statistics, Department of Health (Section 85 only)

PBS Spending Growth across all categories PBS ‘Top 10’drugs Shifting sands for industry The under co-payment market and formularies

Significant change in company sales performance in the past four years Company

Total cost 11-12

Company

Total cost 15-16

Pfizer

$1,487m

Novartis

$830m

AstraZeneca

$1,150m

Pfizer

$725m

Novartis

$627m

AstraZeneca

$574m

Sanofi

$617m

Gilead

$570m

Alphapharm

$498m

Alphapharm

$553m

MSD

$466m

Apotex

$538m

GSK

$414m

MSD

$448m

Janssen

$328m

Bayer

$420m

Apotex

$325m

Sanofi

$415m

Abbott/AbbVie

$322m

AbbVie

$390m

Lilly

$313m

Janssen

$348m

Aspen

$305m

Aspen

$325m

Boehringer Ingelheim

$261m

GSK

$316m

Roche

$188m

Boehringer Ingelheim

$249m

Sandoz

$186m

BMS

$243m

Source: PBS Statistics, Department of Health – total cost to government (Section 85 only)

Generic companies dominated prescription volume in 2015-16 - Market share by PBS prescription Alphapharm

14.4%

Apotex

13.9%

Aspen

8.1%

Pfizer

6.5%

AstraZeneca

6.3%

Sandoz

6.0%

Sanofi

4.9%

MSD

4.2%

GSK

3.7%

BI

2.9%

Servier

2.1%

Fawns and McAllan

2.0%

Mundipharma

2.0%

Bgp Products

1.7%

Novartis

1.7%

Arrow

1.4%

Bayer

1.3%

Amneal

1.2%

Janssen

1.2%

Alcon

1.1%

Source: PBS Statistics, Department of Health – Prescription volume market share (Section 85 only)

PBS Spending Growth across all categories PBS ‘Top 10’drugs Shifting sands for industry The under co-payment market and formularies

A steady increase in the number of PBS prescriptions dispensed under co-payment 83,043,126 79,031,195 72,322,451 62,019,470

12-13

13-14

Source: PBS Statistics, Department of Health (Section 85 only)

14-15

15-16

F2 – increasing share of scripts but rapid decline in share of cost Share of PBS script cost

Share of PBS script volume 77.4%

77.1%

78.5%

52.5%

53.5%

45.7% 45.2% 38.0% 33.5%

16.8%

13-14

16.4%

14-15

14.8%

15-16

13-14 F1

F2

Source: PBS Statistics, Department of Health (Section 85) * Remainder: Combination drugs and Extemporaneously prepared

14-15

15-16