Matching the uptake of biosimilar infliximab seen in other European countries could save enough to offset the £80 million Cancer Drugs Fund overspend
Napp Pharmaceuticals Limited has called for the NHS to prioritise the faster uptake of new biosimilar medicines in order to capitalise on the considerable savings they offer and the potential to improve patient care.
Biologic medicines have transformed the treatment of inflammatory diseases, cancer, diabetes and a wide range of other conditions. However, their high cost along with finite NHS budgets have limited their use in the UK, and in some cases meant that patients who could benefit from them have not had access in the past.1
Biosimilar versions of the biologic medicine infliximab became available in the UK earlier this year for the treatment of inflammatory diseases such as rheumatoid arthritis (RA), Crohn's disease, ulcerative colitis, ankylosing spondylitis (AS) psoriasis and psoriatic arthritis (PsA). This was the first of a new wave of biosimilar medicines due to launch in the UK in the coming years. Discounts currently being offered to the NHS are around 40-50% below the NHS list price of the existing 'originator' infliximab, so changing all patients to one of the biosimilar versions could save the NHS around £90 million2 - easily enough to offset the £80 million overspend reported for the Cancer Drugs Fund in 2014-15.3
However despite practical advice from bodies such as NICE4 and Health Improvement Scotland5 regarding how biosimilar infliximab can be used in place of the original branded infliximab, data shows that uptake in the UK is less than 5% of the original brand.6 This is in contrast to countries such as Denmark, where uptake at 5 months after launch was reported to be 90%.7 In Norway, uptake at 6 months after launch was 20%,8 but has grown steadily to 69% as of July this year.7
This represents a huge missed opportunity for the NHS at a time when some health leaders are warning that the NHS is likely to need emergency funding to deal with the huge deficit it is facing.9
A biosimilar is a biologic medicine that has been developed to be as similar as possible to an existing biologic (the originator medicine). EU-approved biosimilar medicines are subject to a comprehensive licensing process, including comparisons of quality, efficacy, safety and immunogenicity. Approval depends on clear demonstration that there are no clinically meaningful differences and that the biosimilar and the originator are in essence the same active substance.10
With a reduced medicine cost, biosimilar medicines could improve patient care through wider or earlier access for appropriate patients. Furthermore, the money saved through wider uptake could also be reinvested back into local services for patients or used to improve funding for innovative new medicines.
"The NHS has missed out on significant cost savings over the past six months due to the lack of uptake of biosimilar infliximab; cost savings that are vital when the NHS is seeking over £20 billion in efficiency savings", said Andrew Roberts, Director of Market Access at Napp. "There needs to be clear guidance and a robust system of accountability to drive faster adoption of biosimilar medicines at the CCG and Hospital Trust level. Only then can the NHS truly take advantage of the multiple benefits they will bring in the coming years and pass those benefits on to patients through improved services and increased access to medicines."