Switching From Reference Biologic to Biosimilar Maintains High Utilization

A study of data from the United Kingdom presented at the 2017 ACR/ARHP Annual Meeting found that retention is high for rheumatoid arthritis (RA) patients who switch from Remicade to one of the available biosimilar products.

“Biosimilars, biopharmaceuticals assessed by regulatory agencies to have efficacy and safety similar to their reference products, were introduced to the United Kingdom market in February 2015 for RA,” Diederik De Cock, PhD, MSc, BSc, of the Division of Musculoskeletal & Dermatological Sciences at the University of Manchester, and colleagues wrote. “Switching patients from originator to biosimilars could result in significant costs savings to the National Health Service but real world data about efficacy and safety of such a switch are lacking.”

The researchers studied utilization of two Remicade (infliximab; Janssen) biosimilars, Inflectra (infliximab-dyyb; Pfizer) and Remsima (N/A; Celtrion); and a biosimilar to Enbrel (Etanercept; Amgen), Benepali (N/A; Samsung Bioepis). Remsima and Benepali are not approved in the United States; however, Remsima is expected to hit the US market in 2018.

At time of initiation the researchers studied 1165 patients for previous biologic exposure, switching therapies, and reasons for switching. At follow-up were recorded every 6 months for 3 years. The researchers measured disease activity, adverse events, and therapy changes at each follow up.

Study results showed that 59% of patients switched directly from a reference product during the study period, with the majority (74%) switching from Enbrel to Benepali. 

The researchers stated that patients switched products due to cost reasons. Results showed that these patients switched after an average of 5.3 years using the reference product and most had low disease activity.

“RA patients are actively switched from originator to biosimilars mostly for cost reasons,” the researchers noted. 

They also found that retention was high among study participants, with 85% of patients remaining on the biosimilar product after 6 months. The researchers added that 7% of patients switched back and 4% switched to a different biosimilar product.

“Limited short-term follow up data seem to indicate a high retention on biosimilars, yet a minority of patients had a clinically significant deterioration of their disease activity and some were reported to switch back to the originator already after 6 months of treatment,” Dr De Cock and colleagues concluded.

—David Costill

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