Biosimilar switches and healthcare gains

Despite being used across Europe for more than a decade, biosimilar medications are still something of a mystery among those outside the sector.

Mass education is needed if our healthcare systems, not to mention the pharmaceutical industry, are to reap the benefits of these highly similar – and ever more prevalent – versions of biologic medications.

Biosimilars are not new, in fact the European Medicines Agency (EMA) approved its first in 2006. Yet more than a decade later, just 6% of the general population has even the vaguest idea of what they are.

And that matters because a new wave of these medicines is breaking that could save healthcare systems millions if healthcare professionals and their patients can be convinced of the benefits of biosimilar switches.

Market access guaranteed

The UK’s NHS estimates it can save up to £300m a year by 2021 if it can increase the speed at which biosimilars get a foothold in prescribing patterns. Hospitals signed up to the Medicines Optimisation Commissioning for Quality and Innovation (CQUIN) have already committed to switching the majority of their patients to biosimilar products as and when they become available.

This process starts with new patients. But people with conditions including inflammatory bowel disease, multiple sclerosis and rheumatoid arthritis across Europe are being primed for biosimilar switches.

Many parts of the pharmaceutical sector also stand to benefit from this high-level cheerleading, if governments and their healthcare systems can effectively help to clear barriers.

Shared decision making

Internationally, the advice is to apply the principles of shared decision making to switching from a branded biologic medication to an equivalent biosimilar. That can be a big conversation.

An international survey of more than 3,000 people in 2015 found 70% of the general population said they had “never heard of biosimilars”.

This figure was slightly more promising in those among people living with a chronic condition, with between 9% and 30% saying they had “at least a general impression” of what they are. But in the EU, almost half of those surveyed who had a diagnosis and were not involved in an advocacy group had never heard of biosimilars.

The survey also confirmed that people who are more aware of biosimilars were also more informed about their efficacy and safety profile. This was linked to their willingness to switch, and the survey’s authors concluded there was an “immediate need” for patient education.

How similar is biosimilar?

Healthcare professionals need tools to help explain what a biosimilar is, why it’s not simply a generic version of a biological medicine and how the evidence stacks up.

Educated patients are in a better position to see the benefits of a biosimilar. But the industry needs to remember the benefits that matter to a patient, or even a healthcare system, will not necessarily be the same as those that resonate with payors.

NHS England’s decision to wholeheartedly embrace biosimilar switches as each products gets the EMA stamp of approval, for example, is based on cost.

It doesn’t take into account all those added extras that manufacturers of big name branded drugs offer and that make a difference to how treatment decisions are made on the ground: things like pharma-funded patient support programmes and device training services.

Guaranteed market access doesn’t guarantee prescriptions.

Brand-added value

When a patent expires, there are usually a clutch of biosimilars waiting in the wings. The launch and ongoing sales and support services related to these drugs do not fit into the existing model.

Helping to educate patients on the nuts and bolts of biosimilars, it could be argued, helps your company’s competitors get their message across. This, however, assumes the prescription decision is based on the cost of the molecule rather than the value of brand.

One important factor that influenced patients’ willingness to try a biosimilar in the 2014 survey was the manufacturer.

Almost a third, 28%–29%, of people living with a diagnosis said the manufacturer’s identity was “very influential” in their decision.  A further 10%–14% said this information was “extremely influential”.

Between 46% and 48% of patients who had been involved with advocacy groups indicated the biosimilar manufacturer was “very” or “extremely” influential in their decision.

Existing decision tools

Of course, tools designed to help create a biosimilar-versed patient group do exist. One such example is the fact sheet for patients that was developed by the European Commission and published last year.

But it’s the companies that make these molecules that are at the cutting edge of how they are being used in practice. They hold the key to contemporaneously sharing the real-world evidence healthcare professionals need to put things like extrapolated data into the context of people’s everyday lives.

New, similar world

New biosimilars are coming online all the time, and this new class of medications represent a huge opportunity for those phama that are involved with biosimilars and healthcare systems alike.

By using its well-established links and relationships within the therapy areas, the industry can make sure everyone is in the position to seize the opportunity of biosimilar switches.

About the author: 

Amanda Barrell is a health and medical education journalist, editor and copywriter. She has worked on projects for pharma, charities and agencies, and has written extensively for patients, healthcare professionals and the general public.