A new targeted biologic for the estimated 19,000 Australian adults living with severe chronic plaque
psoriasis1 will be listed on the Pharmaceutical Benefits Scheme (PBS) on February 1, 2019 for those who
meet the reimbursement criteria.
ILUMYA™ (tildrakizumab) belongs to a new class of biologic medicines, known as interleukin (IL)
inhibitors, that specifically block a protein called IL-23, an inflammatory substance known to play a key
role in psoriasis.
The treatment, which involves skin injections every 12 weeks, following an initial dose
at day one and another dose at week four, can be stored outside a refrigerator for up to 30 days.
ILUMYA’s PBS listing announcement coincides with an article published in MJA Insight this week
highlighting the substantially unrecognised burden of psoriasis and general lack of awareness among
GPs and the broader patient community, of the availability of new biologic therapies, which may be
delaying patient access to effective, long-lasting treatment.
According to article author, clinical dermatologist and Director of Research, Skin & Cancer Foundation
Inc., Associate Professor Peter Foley, Melbourne, although there is no cure for the debilitating disease,
the introduction of targeted biologics represents a promising step forward in improving patient quality
“While psoriasis was once thought of as little more than ‘influenza of the skin’, our improved
understanding of this immune-driven disease has led to the development of much more targeted
“We now know that the protein, IL-23, plays a major role in the disease, and that blocking its action can
disrupt the psoriasis pathway, relieving inflammation and reducing painful symptoms,” A/Prof Foley said.
“These medications [IL-23 inhibitors] represent the latest development of targeted biologics for severe
psoriasis. The availability of these new treatment options aimed at improving patient quality of life are
welcomed by physicians.”
Psoriasis affects between two to six per cent of Australians and the most common form of the disease,
plaque psoriasis, accounts for up to 90 per cent of cases. It often appears as patches of thick, red, scaly
skin, known as ‘plaques’, that can become itchy and painful, with the potential to crack and bleed.
The immune-driven disease poses a significant physical, psychological and social burden, and can
significantly compromise a person’s quality of life. It is associated with several other health conditions,
including heart disease and arthritis, and disfiguration, disability and marked loss of productivity are
the most commonly cited challenges faced by those afflicted.
Heightened rates of clinical depression and anxiety have also been observed among those living with
psoriasis, and social exclusion, discrimination and stigma are some of the psychologically taxing hurdles
endured by people living with psoriasis.
Although it is unclear whether the psychosocial problems associated with psoriasis are a result of
inflammation related to the disease itself, to stigmatisation or to treatment failure, research indicates an
association between increased control of psoriasis symptoms and improvements in psychological
Clinical dermatologist and Principal, St George Dermatology, Associate Professor Stephen Shumack,
OAM, Sydney, hopes enhanced education and awareness of the availability of new biologics for
plaque psoriasis will improve patient access to treatment and subsequent outcomes.
“Many people were historically told their psoriasis was just a cosmetic problem and that there was
nothing that could be done, or may have been unable to find a treatment that worked for them.
“Lack of patient awareness of the availability of these new treatments, PBS restrictions and poor
information dissemination to GPs, may be discouraging patients from seeking medical attention,
or delaying referrals to dermatologists, subsequently hindering patient access to these potentially
life-changing treatments,” A/Prof Shumack said.
“Australians living with severe plaque psoriasis should no longer despair, as we now have more options
than ever available to effectively manage plaque psoriasis and maintain this in the long-term.”