Balancing costs and care: evaluating the need for novel therapies for immune‐mediated inflammatory diseases in Australia

The prevalence of immune-mediated inflammatory diseases (IMIDs) is rising, associated with increasing disease burden and healthcare expenditure. Medical therapy is the major driver of healthcare costs associated with IMIDs, owing to the need for lifelong therapy. However, many patients exhaust medical options, highlighting the need for new therapies with novel mechanisms of action. Recently, a highly effective class of medical therapy gained registration for use in Australia for IMIDs but was unsuccessful in attaining Pharmaceutical Benefits Scheme reimbursement. There is a growing need to reevaluate the reimbursement process for medicines in Australia, aiming to balance access to new therapies with prudent health-economic policy.