Tocilizumab Shortage

04 May 2022

The shortage of SC tocilizumab preparations has been resolved. This information has been published on the TGA's medicine shortage reports database on the 3 May 2022.

The Serious Scarcity Substitution Instrument (SSSI) for the SC preparations of tocilizumab has now lapsed due to this improvement in supply. 

The TGA webpage Serious Scarcity Substitution Instruments (SSSIs) is in the process of being updated to reflect the lapsing of the SSSI. 

Please note that the supply of IV tocilizumab remains constrained and the current shortage notifications for these preparations are still in place. As per our communication in early March 2022 (below) the supply of IV preparations will be limited to 50% of pre-pandemic levels until mid 2022.

 

04 March 2022

IV Tocilizumab Supply Update

The ARA met with representatives from the TGA, Arthritis Australia and Roche last week. The stock levels of IV tocilizumab continue to improve but remain constrained. Roche confirmed that the supply will be limited to 50% of pre-pandemic levels until mid 2022.  While this is enough to ease the current severe shortage it is not enough to completely resolve the situation. We would like to thank rheumatologists who have worked with their patients to reduce the use of IV tocilizumab by 75% during this severe shortage which has allowed continuing supply to those most in need. This is a great achievement and has not been replicated in other countries. 

Modelling by the TGA has demonstrated that given the recent increase in supply of IV tocilizumab there can be some further changes to the recommendations for use for those patients who are currently or previously on IV tocilizumab. 

Therefore, the ARA recommend that

Systemic juvenile idiopathic arthritis (sJIA) patients and polyarticular juvenile idiopathic arthritis (pJIA) patients 

  • Patients undergoing IV tocilizumab treatment for sJIA and pJIA may resume their normal dosing regimen. 
  • Patients with sJIA and pJIA can be initiated on IV tocilizumab if required.

Adult rheumatoid arthritis patients

  • Adult patients who have been continued on IV tocilizumab treatment for rheumatoid arthritis during the shortage may resume their normal dosing regimen if dosing intervals have been increased during the shortage. 
  • For those adult patients who were previously on IV tocilizumab and were switched to alternative biologic or targeted synthetic agent due to the tocilizumab shortage but are now experiencing flare may resume IV tocilizumab.
  • Adult patients who were switched from IV tocilizumab to abatacept can be switched back to IV tocilizumab.
  • Consider initiation of IV tocilizumab in adult RA patients if clinically indicated.

During the shortage the amount of IV tocilizumab supplied to hospitals was significantly reduced, we have been reassured by Roche that these amounts will increase following this latest shipment. To be clear the amounts available to hospitals will still be reduced compared to pre-pandemic levels. 

Please find below links to resources that may be useful during this shortage. 

Useful links for Patients

  • More information for patients including frequently asked questions can be found on Arthritis Australia's website here

Additional useful links

  • Further information can be found on the TGA website here
  • PBS Arrangements for tocilizumab shortage can be found here
  • More information for ARA Members including a webinar can be found here
  • Roche Medical Information can be contacted on 1800 233 950