Ireland Makes a Push to Switch to Biosimilar Adalimumab and Etanercept

Irish hospitals will be offered a €500 (US $561) incentive for each patient switched from brand-name Humira or Enbrel to a biosimilar option.

The Irish Times reports that the incentives, which will be paid to hospitals rather than to individual prescribers, are part of an effort to switch half of Irish patients receiving these drugs to cost-saving options.

If successful, the approach could save approximately €50 million (US $56 million) in drug costs, and €8.7 million (US $9.7 million) of those savings would be put back into the national healthcare system.

Ireland is undertaking the program in response to low rates of switching to biosimilars, despite the availability of biosimilar options to these 2 high-cost therapies; since biosimilar etanercept became available, it has captured just 1.8% of the market for etanercept.

Ireland’s Medicines Management Program (MMP), a body that promotes cost-effective drug prescribing, began an evaluation process in early 2019 under which it reviewed the use of currently reimbursed anti—tumor necrosis factor (anti-TNF) therapies, which the MMP’s roadmap for prescribing best-value biologics noted represent the highest-expenditure category for Ireland’s reimbursement plan, comprising nearly one-third of drug spending.

Then, in May 2019, the MMP released its guide to best-value biologics for anti-TNFs. The guide recommends that prescribers use Samsung Bioepis’ Imraldi (which as an acquisition price of €623.46, or US $700, for a pack of 2 40-mg injections in prefilled syringes) in place of brand-name Humira (after rebate, €781.48, or US $878), or the citrate-free Amgevita, sold by Amgen (€662.83, or US $744) if needed.

In place of brand-name Enbrel (with an after-rebate acquisition cost of €358.29, or US $402, for a pack of 4 prefilled syringes with doses of 25 mg each), MMP recommends prescribing Samsung Bioepis’ Benpali (€354.53, or US $389). These recommendations apply to new start and to already-treated patients.

According to the MMP, acquisition costs, indications, formulation, product ranges (including pack sizes and strengths), administration devices, supply to the Irish market, and other relevant factors were considered in developing these recommendations.