Biosimilars to gain ground following NICE’s RA guidance

Final guidance issued today by England's NICE has recommended seven biologic drugs for rheumatoid arthritis (RA) – and says treatment should begin with the least expensive.

This means biosimilar drugs, such as Hospira's Inflectra and Napp's Remsima will gain ground on established biologics such as MSD's Remicade, Pfizer's Enbrel and AbbVie's Humira.

Biologics are now routinely given to RA patients who fail to respond to conventional disease-modifying drugs, and have been a huge step forward in treating the debilitating disease.

But spending on the drugs has rocketed over the last decade, and they are now one of the biggest cost centres in the NHS medicines bill.

Inflectra and Remsima are the first biosimilar RA drugs to hit the market (being versions of Remicade, infliximab) and are 50% cheaper than MSD's drug.

Also approved in the finalised guidance are newer entrants to the field, such as UCB's Cimzia (certolizumab), MSD's Simponi (golimumab), Roche's RoActemra (tocilizumab) and Bristol-Myers Squibb's Orencia (abatacept).

However these drugs have only been recommended by NICE after the companies agreed to cut their prices via patient access schemes.

The runaway market leader is Humira, with England's health service spending £311 million on the drug in 2013/14, an increase of 12.5% over the previous year. Like its rivals, Humira is licensed for a range of indications, but much of this figure is for RA treatment.

Of all the drugs approved by NICE, Humira is top of the list, and doctors will be urged to switch away from AbbVie's drug to the cheaper biosimilars wherever possible.

The guidance states that treatment should be started with the least expensive drug (taking into account administration costs, dose needed and product price per dose).

In November, NHS England told pharmaphorum it was considering creating new incentives to help speed the uptake of biosimilars, such as allowing trusts to keep any savings made from switching to the cheaper treatments.

Meanwhile, a biosimilar version of Humira could be on the market soon – Amgen filed its ABP 5O1 with European regulator the EMA in December.

Read the full NICE guidance here.