NHS Releases Commissioning Framework for Biologics, Biosimilars

Last week, England’s National Health Service (NHS) released a commissioning framework for biological medicines, including biosimilars.

The framework, authored by the NHS’ Medicines, Diagnostics, Personalized Medicine Policy Team, explains that NHS England spent £16.8 billion ($21.6 billion) on medicines from 2015 to 2016, an 8% increase in spending over the prior year. Of the top 10 medicines prescribed, 6 are biologics. Using biosimilars could save the health system £200 million to £300 million ($270 million to $404 million) per year by 2020 to 2021, and those savings could be used to fund innovative treatments or improvements in care.

The framework proposes that at least 90% of new patients be prescribed the “best value biological medicine” within 3 months of the launch of a biosimilar for a given reference product, and that 80% of existing patients be prescribed the “best value” medicine within 12 months of a biosimilar’s launch.

The authors point to the NHS’ successes with biosimilars over the past 10 years; 80% of NHS patients receiving infliximab are now treated with a biosimilar, and 58% of patients receiving etanercept are treated with a biosimilar. The cost savings achieved by the health system through using these biosimilar options total £160 million ($216 million) per year. However, uptake of biosimialrs has been uneven in England; the framework indicates that 2 NHS trusts, both located in London, had uptake levels of biosimilar infliximab of 25% and 99%. This difference in rates shows, the authors say, a “significant opportunity” to improve uptake of biosimilar medicines.

With biosimilar rituximab now available in the European Union, and with biosimilars of trastuzumab and adalimumab expected to be available in December 2017 and October 2018, respectively, “It is now important for the NHS to embed the principles of switching to the best value biological medicine into commissioning and clinical practice, if we are to [realize] the optimal rate and extent of savings associated with these medicines,” say the authors.

The framework calls upon NHS commissioners to work with relevant stakeholders, including regional pharmacists and procurement specialists, and to partner with Regional Medicines Optimisation Committees (RMOCs) across England. RMOCs will coordinate with local providers to increase the use of the best value biologics, and will ensure that plans to transition to such medicines are in place by the end of 2017.

Healthcare providers are asked to keep up to date with local policies on switching to biosimilars, and should ensure that they know what they spend on biologic treatments. Finally, the framework also has a recommendation for patients: those receiving treatment with biologics should ask their healthcare providers if there are suitable biosimilar options that they may receive for treatment.