Two new treatments for bone-thinning disease

PHARMAC is funding two new treatments for the bone-thinning disease osteoporosis.

Raloxifene (Evista) and teriparatide (Forteo) will be fully funded following an agreement PHARMAC has reached with pharmaceutical company Eli Lilly. The agreement also includes a long-acting injectable form of the antipsychotic medicine olanzapine.

Osteoporosis mainly affects older women and is characterised by reduced bone mineral density that makes sufferers more likely to fracture bones.

PHARMAC Medical Director Dr Peter Moodie says the aim of osteoporosis treatments is to prevent further bone loss.

PHARMAC already funds three treatments for osteoporosis – alendronate, etidronate and zoledronic acid. All are of the same drug type (bisphosphonates), while raloxifene and teriparatide are from different drug classes.

These differences mean doctors can better tailor treatment to individual patients, says Dr Moodie.

“The side effects of bisphosphonates means that some patients find it difficult to tolerate them, or simply cannot take them,” says Dr Moodie. “Our clinical advisory committee PTAC considered that it would be useful to have a funded treatment with a different mechanism of action for patients who could not take bisphosphonates.

“We think that raloxifene and teriparatide will help meet that need.”

The new drugs will be funded under Special Authority criteria. Raloxifene will be subject to the same access criteria as alendronate and zoledronic acid, while teriparatide will be a ‘last line’ treatment for patients with severe osteoporosis who have experienced fractures despite taking other funded treatments.

“Teriparatide is a relatively new agent with only limited long-term clinical data,” says Dr Moodie. “The available data shows it is effective in reducing the risk of vertebral and non-vertebral fractures.”

The other product included in the agreement with Eli Lilly is a long-acting injectable form of the antipsychotic olanzapine. Olanzapine is already funded as a tablet and as an orodispersible tablet.

Overall, PHARMAC estimates the agreement will lead to a $9.8 million increase in pharmaceutical spending over five years, which will be partially offset by a rebate arrangement with Eli Lilly.