Influence of biosimilar infliximab launch on the utilization pattern of biological medicines: the case of Hungary

Abstract

Objectives: Utilization of multisource biological (off-patent originator and its biosimilar) medicines can improve the efficiency of resource allocation by 1) generating savings while maintaining health outcomes or 2) increasing the number of patients treated with more affordable treatments. This study evaluates the efficiency of the Hungarian biosimilar drug policy on the case of biosimilar infliximab. Methods: We analyzed the utilization of biologicals in all reimbursed indications of infliximab including initial therapy of new patients and switching patterns retrospectively based on patient-level payer's data between September 2012 and December 2016. Results: Despite the economic rationale, patent expiry did not manifest in increased utilization of multisource infliximab in an access-restricted environment: 1) Patients previously treated with original biologicals were switched mainly to other original biologicals instead of more affordable biosimilar alternatives. 2) Although some treatment-naive patients started on more affordable multisource infliximab with price competition, the majority of new patients started on other original biologicals with monopolistic price. Conclusion: Policy tools and measures should be developed to facilitate first-line use of multisource biologicals for treatment-naive patients and promoting the use of more affordable multisource biologicals in case of switching. ARTICLE HISTORY

Utilisation Trend of Long-Acting Insulin Analogues including Biosimilars across Europe: Findings and Implications

“…The growth in the utilisation of the biosimilar in Hungary is also welcomed as this was not the case with biosimilars for infliximab and rituximab [124,125]. However, there are now ongoing reforms in Hungary to encourage physicians to start patients on the least expensive biosimilar as well as the reference pricing system with patients required to fund the difference in prices between the originator and any biosimilar themselves [126].…”

The long-term effects of the biolicit procedure for original and biosimilar GCSF and EPO products in Hungary

“…The potential benefit of biosimilars in improving patient access to biological therapies were described in previous studies [27,29]. The research study carried out by Harsányi et al could not confirm the assumption that the advent of biosimilar products enhanced the availability of the biological therapies for the patients [26]. Kaló et al described the two conflicting factors influencing the cost-saving potential of off-patent pharmaceutcials, namely price erosion and drug utilisation, therefore, we also included the DOT based evaluation in our study [28].…”

“…Initially, it was of utmost importance to prioritise the concept of biological or biosimilar drugs. [1] The introduction of biosimilar products to the drug market made it possible to choose from multiple available drugs thus generating a price competition which inevitably means a significant decrease in source outflow for the social security authorities [2,[26][27][28][29].…”

The Impact of Reimbursement Practices on the Pharmaceutical Market for Off-Patent Medicines in Slovakia

“…However, the specific plan for biosimilar policies can be defined differently in countries experiencing significant resource limitations, where access to expensive reference medicines is limited ( Brodszky et al, 2016 ; Inotai and Kaló, 2019 ). In countries with limited or no access to reference medicines, the key benefit of biosimilars is not related to their cost-saving potential; therefore, the target for biosimilar policies should be characterized from an investment point of view ( Elek et al, 2017 ; Harsányi et al, 2020 ) by increasing patient access and by improving the number of treated patients ( Inotai et al, 2018 ; Ferrario et al, 2020 ).…”