title: Anti-tumour necrosis factor-alpha treatment for perianal Crohn's disease in Australia.
abstract: OBJECTIVE
  To examine the prevalence of perianal Crohn's disease (PCD) and the eligibility of PCD patients to access anti-tumour necrosis factor-alpha (anti-TNFalpha) treatment under current Australian Pharmaceutical Benefits Scheme (PBS) guidelines.
  
  
  METHODS
  A retrospective study of patients with Crohn's disease (CD) and PCD attending four large adult inflammatory bowel disease (IBD) centres in Australia between January 2004 and May 2008. Patients for whom anti-TNFalpha therapy was clinically indicated were assessed to determine whether they satisfied PBS criteria for subsidised medication.
  
  
  METHODS
  Prevalence of CD and PCD in patients attending different IBD centres; eligibility of PCD patients for PBS-subsidised anti-TNFalpha medication.
  
  
  RESULTS
  Data were available on 3589 patients, representing about 6% of all patients with IBD in Australia. Of the 1815 patients with CD, 310 (17%) had PCD. Anti-TNFalpha therapy was deemed clinically indicated for 166 patients with PCD (54%), of whom 49 (30%) did not qualify for PBS-funded therapy.
  
  
  CONCLUSIONS
  Thirty per cent of patients with clinically significant PCD currently do not have access to PBS-subsidised optimal medical treatment. We believe that PBS criteria should be extended to include this subgroup of IBD patients.
authors.affiliation: Department of Gastroenterology, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia.
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Burger
authors.forename: Ian C
authors.initials: IC
authors.lastname: Lawrance
authors.forename: Peter A
authors.initials: PA
authors.lastname: Bampton
authors.forename: Ruth
authors.initials: R
authors.lastname: Prosser
authors.forename: Anthony
authors.initials: A
authors.lastname: Croft
authors.forename: Kristen
authors.initials: K
authors.lastname: Gilshenan
authors.forename: Graham L
authors.initials: GL
authors.lastname: Radford-Smith
authors.forename: Timothy H
authors.initials: TH
authors.lastname: Florin
mesh_terms: D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D001315:Australia; D015331:Cohort Studies; D003424:Crohn Disease / Q000188:drug therapy*; D003430:Cross-Sectional Studies; D006801:Humans; D012189:Retrospective Studies; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D000911:Antibodies, Monoclonal; D014409:Tumor Necrosis Factor-alpha