Biosimilar TNF inhibitors led to reduced prices, no increase in availability in Poland
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The emergence of biosimilar TNF inhibitors in Poland led to reduced prices and expenditures, but little improvements in treatment availability, according to data published in Annals of the Rheumatic Diseases.
“In many low-income and middle-income (LAMI) countries (eg, Romania, Poland, Hungary or Bulgaria), high drug prices limit the availability of innovative therapies, including [TNF inhibitors (TNFi)],” Marcin Stajszczyk, MD, PhD, of the Silesian Center for Rheumatology, Orthopedics and Rehabilitation, in Ustro, Poland, and colleagues wrote. “In this setting, biosimilar availability is viewed as a favorable factor that generates savings due to on-market competition and renegotiation of biologic drug prices.”
To determine the impact that biosimilar TNF inhibitor availability may have on health care spending in Poland, Stajszczyk and colleagues conducted a retrospective budget impact analysis. Pertinent data, including drug costs, annual drug budget figures and the number of patients treated were sourced from the Polish National Health Fund. The researchers calculated the value of TNF inhibitors for all patients who were reimbursed for treatment for rheumatic conditions such as rheumatoid arthritis, psoriatic arthritis, spondyloarthritis and inflammatory bowel disease.
In all, the researchers assessed 12,687 treatment courses for infliximab (Remicade, Janssen), etanercept (Enbrel, Amgen) and adalimumab (Humira, AbbVie). They calculated the real-world savings for the public payor, based on an 8-year perspective of TNF inhibitor use, for the time that biosimilars have been available in the country — since 2014 for infliximab, 2016 for etanercept and 2019 for adalimumab.
According to the researchers, biosimilar TNF inhibitors contributed to an estimated savings of more than 243million ($268 million) for the public payor. Of that total, 166 million ($183 million) was attributed to the reduction of costs in treating patients with rheumatic and musculoskeletal diseases. The real-world savings for those values were calculated at 133 million ($147 million) and 107 million ($118 million), respectively, according to the researchers.
In addition, the rheumatology field demonstrated total savings between 68% and 92% across models, depending on the situation, the researchers wrote. Meanwhile, the overall reduction in mean annual treatment cost ranged from 75% to 89%. Based on these results, if all savings were put toward the reimbursement of additional TNF-inhibitor treatments, nearly 45,000 patients with rheumatic and musculoskeletal diseases could be treated.
“This study demonstrates that biosimilar-related reduction in TNFi prices mainly led to reduced expenditure within the RMDs sector of Polish health care,” Stajszczyk and colleagues wrote. “No relevant increase in treatment availability was observed due to limited savings reinvestment into additional TNFi treatments.
“If no systemic changes towards a patient-centric health care model are undertaken, we can expect only a modest yearly increase in biologic drug access, for which the observed rate of change is still likely driven by low starting drug availability,” they added. “Our findings illustrate the extent of real-life (in contrast to the expected) patient-level benefits in an LAMI countries, and demonstrate how a reductive fiscal policy (with stringent reimbursement and restrictive prescription) constricts biologic accessibility.”
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