title: Changes in use of disease-modifying anti-rheumatic drugs in Australia over the period 1992-2004.
abstract: OBJECTIVE
  Evidence is growing that early use of disease-modifying anti-rheumatic drugs (DMARDs) and combinations of these drugs provide optimal care for people with rheumatoid arthirits. The aim of this study was to describe objectively the pattern of consumption of DMARDs in the Australian community (community-based prescribing, specialist and general practitioner) 1992-2004, and to compare this with prescribing patterns reported in other countries.
  
  
  METHODS
  Dispensing statistics from the Pharmaceutical Benefit Scheme (PBS-Australia's universal prescription subsidy scheme) were analysed and temporal trends evaluated. Drug consumption was calculated as the number of dispensed defined daily doses (DDD)/1000 inhabitants/day (WHO ATC/DDD classification 2005).
  
  
  RESULTS
  The consumption of DMARDs in the Australian community increased steadily from 2.6 DDD/1000 inhabitants/day in 1992 to 5.5 DDD/1000 inhabitants/day. Over the period 1992-2004, methotrexate (MTX) was the most commonly used DMARD (from 0.6 to 3.0 DDD/1000 inhabitants/day). Consumption of gold (parenteral and oral) and penicillamine declined during this time. The inclusion of leflunomide on the PBS in 2000 contributed to the increase in DMARD usage.
  
  
  CONCLUSIONS
  Use of DMARDs within the Australian community has increased in recent years, coinciding with the change in guidelines for therapy for rheumatoid arthritis (RA) to earlier use of DMARDs and the more common use of combinations. This study used DDD methodology to quantify trends for DMARD consumption and these trends are broadly consistent with international prescribing patterns assessed using different methodologies.
authors.affiliation: School of Pharmacy, The University of Queensland, Brisbane, Qld., Australia.
authors.forename: Vivien
authors.initials: V
authors.lastname: Chan
authors.forename: Susan E
authors.initials: SE
authors.lastname: Tett
mesh_terms: D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001315:Australia; D004363:Drug Utilization / Q000639:trends*; D006801:Humans; D013997:Time Factors
chemical_list: D018501:Antirheumatic Agents