Potential Cost Implications of Mandatory Non‐Medical Switching Policies for Biologics for Rheumatic Conditions and Inflammatory Bowel Disease in Canada

Crosby, Michael P.; Tadrous, Mina; Gomes, Tara

doi:10.1002/cpt.2042

Cited by 18 publications

(18 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…At the time they were introduced, these treatments were a very effective but costly treatment modality. The introduction of biosimilars (“a biological medicinal product that contains a version of the active substance of an already authorized biological medicinal product [originator]” [ 4 ]) several years ago lowered the price of TNFα inhibitor treatment and improved patient access to these treatments [ 5 ]. Biosimilars for three TNFα inhibitors are currently approved.…”

Section: Introductionmentioning

confidence: 99%

Patients Retransitioning from Biosimilar TNFα Inhibitor to the Corresponding Originator After Initial Transitioning to the Biosimilar: A Systematic Review

et al. 2021

View full text Add to dashboard Cite

Background Transitioning patients from an originator to a corresponding biosimilar has been extensively studied in both randomized controlled trials and observational studies. Although transitioning is considered well-tolerated, with no negative impacts on efficacy and/or safety, 2.6-25.8% of patients restart treatment with the originator (retransitioning). Retransitioning to the originator can be considered an indication of biosimilar treatment failure or dissatisfaction with biosimilar treatment. Increasing our knowledge of patients who retransition might help to reduce the number of patients retransitioning. Objective Our objective was to estimate the cumulative incidence of patients who retransitioned from a tumor necrosis factor (TNF)-α inhibitor biosimilar to originator and to explore potential patient, disease, and treatment and implementation strategy factors associated with retransitioning. Method We conducted a systematic literature search in the PubMed, EMBASE, and Cochrane Central Register of controlled trials databases until March 2021. Studies on TNFα inhibitors, biosimilar transitioning, and retransitioning were included. Transitioning was defined as switching from an originator to a biosimilar, and retransitioning was defined as switching from an originator to a biosimilar and back to the originator. Characteristics of the studies were descriptively analyzed. Studies were weighted by the number of patients transitioning, and the primary outcome was the median cumulative incidence of retransitioning. For each of the factors related to patient, disease, and treatment and implementation strategy, studies were stratified according to the categories of that factor. The weighted medians and interquartile ranges (IQRs) of the cumulative incidence of retransitioning in these studies were calculated and compared to explore whether a potential association existed between these factors and the cumulative incidence of retransitioning. Results Of 994 screened publications, 37 were included. The weighted median cumulative incidence of retransitioning was 7.6% (IQR 6.8-17.2). Studies that included only patients with inflammatory bowel disease (6.6 vs. 15.1-17.7% for other indications), included only patients with stable disease (7.0 vs. 13.7% for including all patients), and did not offer retransitioning at the introduction of the biosimilar (7.0 vs. 11.1% for studies that offered retransitioning) reported less retransitioning. In addition, the incidence of retransitioning was lower when extra laboratory monitoring was part of the implementation strategy (1.6 vs. 6.1%) and when gainsharing (patients' healthcare directly benefits from financial savings from transitioning) (1.4 vs. 7.2% for studies without gainsharing) was applied. Conclusions In studies on transitioning patients from TNFα originator to biosimilar, 8% of patients retransitioned. Retransitioning appeared to be lower in studies that included only patients with stable disease and in studies that did not offer patients the option of retransitioning at...

show abstract

Section: Introductionmentioning

confidence: 99%

Patients Retransitioning from Biosimilar TNFα Inhibitor to the Corresponding Originator After Initial Transitioning to the Biosimilar: A Systematic Review

et al. 2021

View full text Add to dashboard Cite

show abstract

“…These policy and regulatory changes, including those within the Patented Medicines Prices Review Board, may mitigate this projected growth and encourage the addition of more biosimilars to the Canadian market, yet their impact on overall cost growth remains unknown. 21,22 The impact of biosimilar uptake is particularly important to understand given that the top 25 drugs in terms of retail and hospital spending have several biosimilars on or about to enter the market. With a number of public and private payers moving toward mandatory switching, we anticipate greater uptake over the coming years across Canada.…”

Section: Discussionmentioning

confidence: 99%

Canadian Trends and Projections in Prescription Drug Purchases: 2001–2023

Tadrous¹,

Shakeri²,

Hayes³

et al. 2021

cjht

Self Cite

View full text Add to dashboard Cite

Limited data are available to understand costs and trends over time in the Canadian pharmaceutical market across all sectors. To fill this gap, a retrospective time series analysis of annual prescription drug purchases in Canada between 2001 and 2020 was conducted using data from the IQVIA Canadian Drugstore and Hospital Purchases Audit. Spending has grown over the past 2 decades at a steady pace, with annual average growth of 5.3% and 7.1% in the retail and hospital sectors, respectively. Total prescription purchases in 2020 were approximately $32.7 billion, 4.3% higher than in 2019 (3.8% growth in retail, 6.9% in hospital). New approvals of specialty and oncology drugs and generic formulations of the top 25 drugs may influence drug purchases in 2021 to 2023. Overall drug purchases in Canada are projected to continue growing. The forecast for the outpatient sector is continued moderate levels of growth in drug spending (3% to 4%), with higher rates of growth (7% to 8%) in the hospital setting. Action should be taken to curb sustained growth in pharmaceutical spending in Canada. Otherwise, these costs may be shifted to other budgets, private industry, and/or patients.

show abstract

“…Some governments have discussed and/or announced the implementation of NMS policies [23][24][25][26]. While several experts support NMS policies [77,78], others have voiced their opposition to such ''forced'' switches for nonmedical reasons [79][80][81]. Moreover, the Canadian Association of Gastroenterology and Crohn's and Colitis Canada released a joint statement wherein they recommend against infliximab originator-to-biosimilar NMS in patients who have stable CD or UC and who are doing well on the reference biologic [82].…”

Section: Discussionmentioning

confidence: 99%

The Economic Impact of Originator-to-Biosimilar Non-medical Switching in the Real-World Setting: A Systematic Literature Review

Hillhouse¹,

Mathurin

Parison

et al. 2021

Adv Ther

View full text Add to dashboard Cite

Introduction To save costs to the healthcare system, forced non-medical switch (NMS) policies that cut drug coverage for originator biologics and fund only less expensive biosimilars are being implemented. However, costs related to the impact of NMS on healthcare resource utilization (HCRU) must also be considered. This study aims to summarize the evidence on the economic impact of an originator-to-biosimilar NMS. Methods A systematic literature review (SLR) was conducted. Publications reporting on HCRU or costs associated with originator-to-biosimilar NMS in the real-world setting were searched in MEDLINE and EMBASE from January 2008 to February 2020. In addition to hand searching the reference lists of relevant publications and SLRs, key conference websites, PubMed, and various government sites were also searched for the 2 years preceding the search (2018–2020). Results A total of 1845 citations were identified, of which 49 were retained for data extraction. Most studies reporting on the HCRU associated with NMS reported on post-NMS HCRU alone without a comparison pre-NMS. However, four studies described a difference in HCRU (i.e., investigations pre- vs post-switch or between non-switchers vs switchers), all of which reported a relative increase in HCRU, including laboratory testing, imaging, medical visits, and hospitalizations, amongst patients who underwent an originator-to-biosimilar NMS. Most studies reporting on the costs associated with NMS reported significant savings following NMS on the basis of drug costs alone. However, four studies specifically reporting on the difference of costs following originator-to-biosimilar NMS all demonstrated an increase in HCRU-related costs associated with NMS (increase in HCRU-related costs of 4–37% or 148–2234 2020 Canadian dollars). Conclusion Amongst the studies that reported on the difference in HCRU pre- vs post-switch or between non-switchers and switchers, all showed an increase in HCRU and related costs associated with NMS, suggesting that the expected overall savings due to less costly drug prices may be reduced as a result of an increase in HCRU and its associated costs post-switch. Nevertheless, more real-world studies that include NMS-related healthcare costs in addition to drug costs are needed. Supplementary Information The online version contains supplementary material available at 10.1007/s12325-021-01951-z.

show abstract

Potential Cost Implications of Mandatory Non‐Medical Switching Policies for Biologics for Rheumatic Conditions and Inflammatory Bowel Disease in Canada

Cited by 18 publications

References 8 publications

Patients Retransitioning from Biosimilar TNFα Inhibitor to the Corresponding Originator After Initial Transitioning to the Biosimilar: A Systematic Review

Patients Retransitioning from Biosimilar TNFα Inhibitor to the Corresponding Originator After Initial Transitioning to the Biosimilar: A Systematic Review

Canadian Trends and Projections in Prescription Drug Purchases: 2001–2023

The Economic Impact of Originator-to-Biosimilar Non-medical Switching in the Real-World Setting: A Systematic Literature Review

Contact Info

Product

Resources

About