Do Favourable Access Conditions and Policies for Biosimilars Result in Increased Consumption in the EU4 and the UK?

OBJECTIVES: Biosimilars can offer advantages for the healthcare system by decreasing overall costs and increasing patient access. Therefore, policies in European countries are aimed at easing biosimilar access to the market. This research aimed to evaluate whether more favourable access conditions for biosimilars (prescription rules, policy, pricing, and reimbursement) resulted in increased consumption, using the cases of infliximab, etanercept and trastuzumab.

METHODS: Pharmaceutical consumption data in Germany, Spain, France, Italy, and the UK was obtained from the AIFA 2020 OsMed report. Complementary desk research investigated policies of national health authorities and regulatory bodies aimed at fostering biosimilars uptake. Countries’ attractiveness for biosimilars was then assessed by ranking consumption on a scale where “low” represented biosimilar consumption ≤50% for each drug, “medium” between 50% and 75%, and “high” >75%, respectively.

RESULTS: All scope countries have facilitated reimbursement for biosimilars. Pricing rules in France, Italy and Spain involve a 20% to 40% discount versus the originator drug. While switching is possible in all countries, in Italy and the UK, prescribers are urged to consider drug costs in their decisions by prescribing the most economically advantageous alternative. This is reflected in a high overall consumption of biosimilars in these two countries (high score for 2 of the drugs and medium score for 1 drug), whereas Spain, France and Germany overall showed medium consumption (medium score for 2 drugs and low score for 1 drug).

CONCLUSIONS: Italy and the UK appear to have highest uptake for biosimilars whereas Spain, Germany, and France seem to be slower in uptake. A possible cause for low consumption could be physicians’ view on biosimilars, whereas incentives and policy recommendations seem to drive uptake. Automatic substitution at the pharmacy level being implemented in Germany and France (second half of 2022) may result in additional growth for biosimilars.