MEDICAL EXPENDITURES DECREASED FOLLOWING POLICY INTERVENTIONS TO ACCELERATE BIOSIMILAR UTILIZATION IN JAPAN: A NATIONWIDE SERIAL CROSS-SECTIONAL ANALYSIS
Author(s)
Takehiro Ishida, DrPH1, Satoshi Yamaguchi, MS2, Yuexiang Ji, MSc Student2, Tomoya Ookado, MBA2, Shu Sasaki, undergraduate2, Ayaka Mukuta, undergraduate2, Suzuho Matsuda, undergraduate2, Amy Crawley, BA2, SHIORI TOSHIMITSU, BA2, Yui Higa, undergraduate2.
1Teikyo University Graduate School of Public Health, Itabashi-ku, Japan, 2GifTs (Glocal Innovator & Future Talent Society), Tokyo, Japan.
1Teikyo University Graduate School of Public Health, Itabashi-ku, Japan, 2GifTs (Glocal Innovator & Future Talent Society), Tokyo, Japan.
OBJECTIVES: The Ministry of Health, Labour and Welfare (MHLW) in Japan introduced a policy to accelerate biosimilar utilization that provided a 1,500 JPY (9.4 US dollars) financial incentive for hospitals to initiate biosimilar to home care patients in April 2020, and this incentive was expanded to outpatient treatments in April 2022.This study analyzed the effectiveness of the newly introduced policy for biosimilar utilization and medical expenditure reduction. This study hypothesized that policy interventions in Japan would lead to an increase in prescription of biosimilars with medical expenditure reduction for biologics.
METHODS: A nationwide serial cross-sectional study was conducted using the national database(NDB) Open Data, which has annual reimbursement claims data in Japan. Research periods were from FY2019 (April 2019-March 2020) to FY2023 (April 2023-March 2024). Prefecture-based outpatient prescription data of biologics was extracted from NDB Open Data.This study set prescribed units per 100,000 inhabitants as an outcome.The mean (95% CI) of prescribed units was analyzed based on prefectures (n=47), and differences between FY2019 and FY2023 were assessed by using paired t-tests. P-value (two-sided) < 0.05 was considered statistically significant. Based on the defined unit price for approved medicines by MHLW, this study calculated biologic expenditure for outpatients as another outcome. This outcome includes expenditure of biosimilar, and reference biologics with approved biosimilar.
RESULTS: The means (95% CI) of biosimilar prescription units per 100,000 inhabitants for outpatients were 2,875 (2,690-3,060) in FY2019, and 7,633 (7,184-8,082) in FY2023. The difference was 4,758 (4,444-5,071) with p-value < 0.001.Biologic expenditure was 3,036 million USD (153 million USD for biosimilar, and 2,883 million USD for reference biologics) in FY2019, and 2,561 million USD (469 million USD for biosimilar, and 2,093 million USD for reference biologics) in FY2023.
CONCLUSIONS: The utilization of biosimilar was accelerated with a reduction of medical expenditure for biologics following policy implementation in 2020 and 2022.
METHODS: A nationwide serial cross-sectional study was conducted using the national database(NDB) Open Data, which has annual reimbursement claims data in Japan. Research periods were from FY2019 (April 2019-March 2020) to FY2023 (April 2023-March 2024). Prefecture-based outpatient prescription data of biologics was extracted from NDB Open Data.This study set prescribed units per 100,000 inhabitants as an outcome.The mean (95% CI) of prescribed units was analyzed based on prefectures (n=47), and differences between FY2019 and FY2023 were assessed by using paired t-tests. P-value (two-sided) < 0.05 was considered statistically significant. Based on the defined unit price for approved medicines by MHLW, this study calculated biologic expenditure for outpatients as another outcome. This outcome includes expenditure of biosimilar, and reference biologics with approved biosimilar.
RESULTS: The means (95% CI) of biosimilar prescription units per 100,000 inhabitants for outpatients were 2,875 (2,690-3,060) in FY2019, and 7,633 (7,184-8,082) in FY2023. The difference was 4,758 (4,444-5,071) with p-value < 0.001.Biologic expenditure was 3,036 million USD (153 million USD for biosimilar, and 2,883 million USD for reference biologics) in FY2019, and 2,561 million USD (469 million USD for biosimilar, and 2,093 million USD for reference biologics) in FY2023.
CONCLUSIONS: The utilization of biosimilar was accelerated with a reduction of medical expenditure for biologics following policy implementation in 2020 and 2022.
Conference/Value in Health Info
2026-09, ISPOR Asia Pacific 2026, Bangkok, Thailand
Value in Health, Volume 55, Issue S1
Code
HPR28
Topic
Health Policy & Regulatory
Topic Subcategory
Insurance Systems & National Health Care, Public Spending & National Health Expenditures
Disease
STA: Biologics & Biosimilars