Health Boards
World Health Organization (WHO) has updated it's list of essential medicines for psoriasis.
Prescribed Treatments For Psoriasis
Source: who.int
Quote:
The Expert Committee considered that the inclusion of effective and safe biologics for psoriasis on the EML would address an important public health need and support global advocacy efforts to reduce the global burden of psoriasis, especially in low and middle-income countries. The Committee acknowledged that a large number of biologic disease-modifying medicines for psoriasis are available and the need to prioritize the most effective, tolerable and affordable options.
The Expert Committee recommended the inclusion of adalimumab and ustekinumab on the complementary list of the EML and EMLc for the treatment of adults and children with moderate-to-severe psoriasis, based on evidence of favourable efficacy and safety, as second line treatment alternatives. Listing complements the non-biologic therapies used in first line for psoriasis currently listed on the Model Lists (e.g. topical corticosteroids, systemic methotrexate).
The Committee considered that adalimumab and other tumour necrosis factor alpha inhibitors could be considered therapeutic alternatives to each other in most clinical scenarios and that including multiple within-class alternatives on the Model Lists could support greater competition to lower prices. The Committee therefore recommended adalimumab be listed with a square box as the class representative with certolizumab pegol, etanercept and infliximab as specified therapeutic alternatives.
The Committee recommended inclusion of ustekinumab in addition to adalimumab because of some advantages ustekinumab has over adalimumab and other tumour necrosis factor alpha inhibitors. When considering the administration schedule, adalimumab is administered every two weeks while ustekinumab is administered every 12 weeks. Less frequent injections are more convenient, with reduced disruption to daily life for patients and reduced burden and costs for health systems. Ustekinumab is preferred to adalimumab in patients with heart disease and in settings where tuberculosis is endemic as it is associated with a lower risk of tuberculosis reactivation. While ustekinumab is currently more highly priced than adalimumab, biosimilars are becoming increasingly available. For ustekinumab, the Committee did not recommend listing with a square box. The Committee acknowledged the data supporting similar or better effectiveness of other monoclonal antibodies targeting IL-12 and IL-23 (e.g. guselkumab, risankizumab and tildrakizumab) but considered the alternatives to have less supportive evidence, biosimilars are not yet available, and there is no information regarding their costs in most jurisdictions which were assumed to be higher than ustekinumab.
Quality-assured biosimilars are recommended as therapeutic alternatives of both adalimumab (and therapeutic alternatives) and ustekinumab.
Prescribed Treatments For Psoriasis
Source: who.int