Abstract
Background: Regions within England, Scotland and Wales show variation in rate of adoption of biosimilar infliximab and etanercept. Objectives: This study aims to examine how local decisions and practices in regions within England, Scotland and Wales might explain initial variation in market dynamics of biosimilar and originator infliximab and etanercept. Methods: Market data provided by the National Health Service (NHS) on biosimilar and originator infliximab and etanercept uptake were analysed for the 10 historical regions of England, 14 health boards in Scotland and 7 health boards in Wales (2015–2018). Findings were discussed in ten semi-structured interviews: on a national level with an industry representative (1), on a regional level with NHS employees in England (6), Scotland (1) and Wales (1), and on a local level with a representative of a clinical commissioning group in England (1). Results: Tenders for infliximab and etanercept in England, Scotland and Wales have consistently resulted in a biosimilar as the best value biological. Early and late biosimilar adopters are seen, with overall convergence towards high biosimilar market shares over time. Qualitative results suggest that biosimilar adoption was positively influenced by (a) a price difference between biosimilar and originator product making it worthwhile to switch patients; (b) a good relationship between commissioner and provider in England resulting in gain share agreements; (c) leadership on biosimilars in regional NHS offices in England or Scottish and Welsh health boards; (d) key opinion leaders or leading hospitals that start using biosimilars early and gain experience. Conclusions: This study has shown that the savings potential drives biosimilar use. Regions with a proactive attitude, good stakeholder relationships, and clinician engagement were identified as early adopters.
| Original language | English |
|---|---|
| Pages (from-to) | 75-87 |
| Number of pages | 13 |
| Journal | BioDrugs |
| Volume | 35 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Jan 2021 |
Bibliographical note
Funding Information:SS, IH and AGV are founders of the KU Leuven Fund on Market Analysis of Biologics and Biosimilars following Loss of Exclusivity (MABEL). SS, IH and AV have conducted biosimilar research sponsored by Hospira (now Pfizer). SS was involved in a stakeholder roundtable on biologics and biosimilars sponsored by Amgen, Pfizer and MSD; he has participated in advisory board meetings for Pfizer and Amgen; and he has contributed to studies on biologics and biosimilars for Celltrion, Mundipharma and Pfizer. AV is involved in consulting, advisory work and speaking engagements for a number of companies, a.o. AbbVie, Accord Healthcare, Amgen, Biogen, Fresenius-Kabi, Medicines for Europe, Pfizer/Hospira, Mundipharma, Roche, Samsung/Bioepis, Sandoz/Novartis. EM, JK, RB, LM and TV declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Funding Information:
This manuscript is supported by KU Leuven and the Fund on Market Analysis of Biologics and Biosimilars following Loss of Exclusivity (MABEL). The Open Access fee was covered via the Open Access Agreement with the Erasmus University Medical Center Rotterdam.
Publisher Copyright:
© 2020, The Author(s).
Research programs
- EMC OR-01