Hospitals missing chance to save £80,000 per month using biosimilar

Hospitals in the UK's National Health Service are missing out on saving millions of pounds because of poor uptake of biosimilars, cheaper versions of expensive biologic medicines.

Among the biosimilar drugs already on the market is anti-inflammatory and immunology treatment infliximab (a copy of Janssen's Remicade) – offering big savings at a time when the NHS is desparate to cut costs.

But some hospitals are already switching to the drug for use in gastroenterology, and saving up to £80,000 per month ($116,868) - and are urging others to follow suit.

The Medicines for Europe annual biosimilars conference in London yesterday heard from Fraser Cummings, consultant gastroenterologist, at University Hospital Southampton NHS Foundation Trust, who pioneered use of the near-copy of Johnson & Johnson/MSD's Remicade (infliximab).

However the South coast hospital is far from typical of the NHS, with data showing that biosimilar uptake remains patchy across the country - a missed opportunity for savings at a time when the health service is under unprecedented financial pressure.

Cummings said that he had initially estimated that the hospital could miss out on savings of up to £800,000, assuming a 50% discount, if it continued to use Remicade in patients with inflammatory bowel disease instead of the biosimilar.

So Cummings switched around 140 patients to Celltrion's Remsima biosimilar a year ago, and has been monitoring them since.

The savings have allowed the hospital to improve care in other ways, such as freeing up cash to hire a dedicated specialist nurse to oversee patients taking the drug and provide support.

He told the conference: "There has been a real drop in what we are spending." Cummings said the savings per month on drug acquisition costs varied between £60,000 and £80,000.

Only two patients took a decision to switch back to Remicade - although Cummings said they stopped treatment shortly after. He suggested these patients may have been suffering the same reaction to both drugs.

Overall, patients had been supportive of the project and its goal to free up cash to improve care standards. "They wanted us to do more for them," said Cummings.

Concerns about slow uptake of biosimilars have led to the formation of the British Biosimilars Association, which will raise awareness of these drugs and the potential cost savings they bring.

Per Troein, vice president strategic partners at IMS Health, noted that both the UK and Sweden had demonstrated "fragmented" decision making over biosimilar use, without real leadership from national organisations.

This was in stark contrast to Nordic countries, such as Denmark, Norway and Sweden, where national agencies have championed use of biosimilars.

Earlier this year NICE gave guidance on seven drugs for severe rheumatoid arthritis, urging the NHS to use the least expensive option. Although this could push NHS hospitals towards using biosimilar infliximab, which can also be used in this indication, the conference heard that stronger incentives are necessary.

Steinar Madsen, medical director at the Department of Drug Information at the Norwegian Medicines Agency, said that a discount of more than 60% meant that all hospitals in the country have switched over to the biosimilar.

But hospitals also receive an incentive from the government to prescribe the cheaper drug, receiving direct cash payments every time they prescribe the biosimilar.