Uptake of Biosimilar Infliximab in the UK, France, Japan, and Korea: Budget Savings or Market Expansion Across Countries?

Abstract

Objective To compare the market dynamics of biosimilar infliximab among four Organization for Economic Cooperation and Development (OECD) countries (UK, France, Japan, and Korea) where supply-side and demand-side policies varied greatly, given high and growing expenditure on biological medicines to treat immunological diseases across countries. Methods A quarterly dataset covering October 2012 to March 2018 was constructed from the MIDAS-IQVIA International database. The sales value (in USD) and volume (in standard units) of originator infliximab and biosimilar products and their relative price in each country were compared. Results With the introduction of biosimilars, the sales value of infliximab increased approximately 2.5 times in Korea, whereas it only slightly increased (1.2 times for France and the UK) or decreased (0.9 for Japan) in other countries. While stable market size dynamics were observed in the other countries, an escalating market size, attributable to the increase in originator infliximab, was observed in Korea. In the UK and France, which have implemented demand-side policies, the sales volume of originator infliximab appreciably decreased after the entry of biosimilar infliximab while that of biosimilars increased; however, in Korea, which has supply-side policies based on price-linking with few demand-side policies, the volume of originator infliximab actually increased by 70% alongside a very limited increase in biosimilar infliximab. The lowest price ratio between biosimilar and originator infliximab was found in Japan, at 68%. In France and Korea, the ex-factory prices of biosimilar infliximab were 99 and 95%, respectively, of the originator infliximab price. In the UK, the ex-factory price of biosimilar infliximab started at 87% of that of originator infliximab and then decreased to 80% as the market matured. However, actual price differences might differ. Conclusion The uptake of biosimilar infliximab varied greatly, and in contrast to the UK, France, and Japan, the introduction of biosimilar infliximab resulted in market expansion in Korea, which might be explained by a lack of demand-side policies in Korea. Both supply- and demand-side measures are necessary for health authorities to achieve desired savings from the availability of biosimilars.

The Expiry of Humira® Market Exclusivity and the Entry of Adalimumab Biosimilars in Europe: An Overview of Pricing and National Policy Measures

“…Earlier papers have also suggested a focus on demand-side policies, such as specific stakeholder incentives, guidelines and education, rather than solely targeting price is important to enhance their use and attain target savings ( Moorkens et al, 2017 ; Rémuzat et al, 2017b ). Target utilization patterns and savings are unlikely without a dual approach ( Kim et al, 2020 ). This dual approach is important to help address discounting tactics by originator companies just before or soon after patent expiry to dissuade biosimilar manufacturers from entry.…”

“…A discussion of general policy measures and practices regarding biosimilars in each country is considered out of the scope of this paper. Several papers have already mapped policies for biosimilars on a national or regional/local level ( Renwick et al, 2016 ; Moorkens et al, 2017 ; Rémuzat et al, 2017a ; Rémuzat et al, 2017b ; Moorkens et al, 2019a ; Moorkens et al, 2019b ; Kim et al, 2020 ; Moorkens et al, 2020 ), although the market is rapidly evolving. This paper reflects some of these changes.…”

Changes in the Penetration Rate of Biosimilar Infliximab Within Japan Using a Japanese Claims Database

“…According to previous research, the market share of infliximab biosimilars reached approximately 89% in the UK, followed by France (48%), and Korea (35%), whereas it was only 6% in Japan, based on the values for quarter one of 2018. 34 Previous studies have shown an obvious discrepancy among the penetration rates of four biosimilar products in Japan, namely insulin glargine, filgrastim, infliximab, and rituximab, among which the biosimilar of filgrastim had the highest penetration rate of 80%, whereas the biosimilar of infliximab had the lowest penetration rate of 5.3%. 12 This discrepancy may be due to differences between products in aspects such as the number of indications and prescriber expertise.…”

Did the Introduction of Biosimilars Influence Their Prices and Utilization? The Case of Biologic Disease Modifying Antirheumatic Drugs (bDMARD) in Bulgaria

“…The cost savings are considered as benefits from the introduction of biosimilars [ 36 ]. Other authors also prove that biosimilars not only decrease the prices but also increase the utilization but still there are concerns for their interchangeability [ 37 , 38 ].…”