Applying Biosimilar Savings in Markets Around the World

The great promise of biosimilars is their ability to provide high-quality treatment at a reduced cost, thereby producing cost savings that can be reapplied. But how are healthcare systems around the globe utilizing those cost savings? During the International Society for Pharmacoeconomics and Outcomes Research 2019 meeting, held this week in Copenhagen, Denmark, several teams of researchers reported on how biosimilars are impacting international markets, and how they could provide headroom for new, expensive treatments.

In the Czech Republic, biologics are reimbursed at 1 price per group. When biosimilars launch, they are reimbursed at 30% lower than the originator product, and as a result, all products in the same group also drop in price by 30%. Researchers from the country’s State Institute for Drug Control reported on their analysis of the change in consumption—and the change in cost—of anti—tumor necrosis factor (anti-TNF) agents after the first biosimilar, infliximab, became available in 2013.¹

Using publicly available data, the team found that consumption of anti-TNFs increased by 87% over 5 years, with infliximab and adalimumab being the most commonly used. In 2018, biosimilars had reached 33% of all market share for anti-TNFs, and biosimilar infliximab overtook the reference in terms of use in 2017.

According to the authors, the availability of a biosimilar infliximab has helped lower unit costs over time, and has allowed for improved access to therapy overall.

Second, a team discussed their assessment of market dynamics in France, the United Kingdom, Japan, and the Republic of Korea.² They used MIDAS-IQVIA data from 2012 to 2018 to assess the sales value and volume for the originator and biosimilar infliximab products available in these countries, and found that the introduction of a biosimilar increased the Korean infliximab market’s value 2.5-fold, and the French and UK markets’ value by 1.2-fold. The Japanese market’s value decreased, however, 0.9 times.

Additionally, in the Korean market, the reference product saw its sales value increase after biosimilar entry, suggesting an expansion of the market for infliximab after the cost-saving biosimilars were introduced.

Finally, UK researchers reported that biosimilar savings could be the key to paying for chimeric antigen receptor (CAR) T-cell therapies and gene therapies in the country’s National Health Service (NHS).³

CAR-T and gene therapies can offer transformational benefits for patients who typically have unmet needs, say the authors, but affordability is still a challenge that needs to be addressed, and biosimilars could play a crucial role. According to the authors, the NHS reaped £200 million (approximately USD $257) from biosimilar infliximab, rituximab, and etanercept alone, and after the launch of biosimilar adalimumab, an additional $300 million (approximately USD $385 million) are expected by 2021.

Approximately 200 patients each year are expected to be eligible for one of the CAR-T therapies, which have UK list prices of £300,000 (approximately USD $385,000) and £282,000 (approximately USD $362,000), respectively. Cumulatively, the budget impact of treating eligible patients with CAR-T therapies is £116 million (approximately USD $149 million) annually.

According to the authors, the savings produced by biosimilar use significantly outweigh the budget impact of introducing CAR-T treatments, and the affordability of new drug classes may be achievable with increased focus on using biosimilars.

References

1. Chytilová P, Haluska M, Mahovská R, et al. TNF-alpha inhibitors in the Czech Republic—how biosimilars affect overall consumption and costs? Presented at: ISPOR Europe 2019; November 2-6, 2019; Copenhagen, Denmark. Abstract PBI13.

2. Kim Y, Kwon HY, Godman B, Moorkens E, Simoens S, Bae S. Uptake of biosimilar infliximab—budget savings or market expansion across countries? Presented at: ISPOR Europe 2019; November 2-6, 2019; Copenhagen, Denmark. Abstract PBI45.

3. Ivonova H, Macaulay R. Unlocking access to transformational CAR-T cell and gene therapies. Are biosimilars the key? Presented at: ISPOR Europe 2019; November 2-6, 2019; Copenhagen, Denmark. Abstract PMU64.