Is It Time to Look Beyond Price With Biosimilars?

In the United States, discussions about the utility of biosimilars in the healthcare system have been squarely focused on price. List price discounts announced alongside product launches have been the cause for debate as stakeholders attempt to make the most sustainable decisions for their health systems and for patients, and while there is no question that falling prices that come with competition are cause for optimism in a nation burdened by rising costs, some experts from Europe caution that a focus on price alone misses key reasons to use biosimilars.

In a narrative review appearing this week in BioDrugs, a team of authors from Belgium and the Netherlands reported on the results of a comprehensive literature search on the benefits of biosimilars as they pertain to the European market. Materials that reported empirical data on the benefits of off-patent biologics and biosimilars in Europe were included, and these materials comprised 16 studies, reports, and guideline updates.

Among those materials were 8 empirical studies, 6 of which used hypothetical budget impact analyses and 2 of which calculated actual savings from UK and Spanish experience. “All of these studies pointed to substantial savings in pharmaceutical costs,” write the authors, with the exception of a 2017 study that showed a budget increase with the market entry of an alternative, new biologic during the study’s time horizon.

A theme that emerged from the review was improvement in cost effectiveness of treatment; lower prices and similar effectiveness allowed biologic therapy to be used in earlier lines of treatment, write the authors, allowing patients to access these treatments at earlier stages in their disease. Overall access to treatment may also improve with biosimilar cost savings; multiple hypothetical budget impact studies have demonstrated that additional patients with the same disease—or patients with other diseases—can be treated with money saved from biosimilars. Patient support and innovative treatments could also be funded with savings gleaned from biosimilars.

Additionally, the authors write that gain-sharing agreements can allow funds to be reinvested in employing more healthcare professionals, thereby reducing patient waiting times for care and improving utilization of healthcare resources.

Competition has also paved the way for innovation among off-patent products; new routes of administration or innovations that promote adherence can result in better patient productivity and overall gains for society.

All of these findings point to the fact that benefits that arise from cost containment have interrelated value for health systems that can result in wider use of biologics in general.

The authors point out, however, that there remain forces that undermine the realization of these benefits. Low uptake due to lack of physician confidence and the nocebo effect in patients are barriers to fully achieving the potential of biosimilars.

Reference

Dutta B, Huys I, Vulto AG, Simoens S. Identifying key benefits in European off-patent biologics and biosimilar markets: it is not only about price! [published online December 2, 2019.] BioDrugs. doi: 10.1007/s40259-019-00395-w.