Recent Reports Explore Drug Survival, Cost Savings in Switches to Biosimilar Etanercept

Patients with inflammatory diseases in the United States continue to wait for the availability of a biosimilar etanercept, despite the 2016 approval of Erelzi and the 2019 approval of Eticovo.

However, in the European context, biosimilar etanercept is already available, and recently presented data demonstrate that, in some countries, use of the biosimilar is high and making an impact on healthcare costs.

In Norway, which is among the countries that has been the most aggressive in controlling healthcare expenditures on pharmaceuticals through the use of price regulation and substitution, multiple data registries are available that can be used to track biosimilar use.

A team of investigators used these Norwegian databases to study all patients who were receiving maintenance therapy with etanercept for 9 months before biosimilar availability who then switched to the biosimilar.¹ In total, 4799 patients were included.

A total of 70.5% of reference etanercept users were switched to biosimilar SB4 (sold as Benepali in Europe, approved as Eticovo in the United States) from the originator, while 5.7% of patients switched to a different drug altogether after biosimilar availability. For patients who switched to the biosimilar, at 18 months, drug survival was 72% (95% CI, 65%-79%).

The investigators will continue to follow these patients, and at 2 years, drug survival in those who switched will be matched with historic drug survival rates estimated from existing data to provide further insight.

Other European nations have had different levels of biosimilar use, including Spain, where individual, self-governing regions make decisions on strategic plans regarding the choice of products.

Data recently presented from a study of patients in a tertiary hospital in the Murcia region of Spain show that in a setting where switching to biosimilar etanercept was conducted only after gaining patient agreement, substantial cost savings were still possible.²

The study relied on a registry of 133 patients treated in the rheumatology department of the single center, 56 of whom were consulted about switching to the biosimilar. Eventually, 55% of those consulted made the switch after agreeing to use the biosimilar.

Among the patients who did not switch, reasons included moderate or high disease activity, remission, or lack of acceptance of the switch.

According to the researchers, annual costs per patient were €9143.16 (US $10,255.65) for originator etanercept versus €6095.44 (US $6837.10) for the biosimilar, for a total cost savings for all switched patients of €94,479.32 (US $105,975.09).

References

1. Smastuen MC, Madla R, Solli O, Hjelvin E. Retrospective analysis of prescription dynamics of etanercept after introduction of biosimilars based on Norwegian prescription database. an interim analysis. Presented at: The European League Against Rheumatism European Congress of Rheumatology 2019; June 12-15, 2019; Madrid, Spain. Abstract OP0311.

2. Dayer PVC, Sara JR, Belando CG, et al. Switching of etanercept in a monographic consultation of biosimilar clinical practice and economic cost. Presented at: The European League Against Rheumatism European Congress of Rheumatology 2019; June 12-15, 2019; Madrid, Spain. Abstract AB1202.