Presentation (CTI)

OBJECTIVES: Saudi Arabia’s Council of Health Insurance (CHI) has prioritized rational prescribing through the implementation of the International Nonproprietary Name (INN) policy, aiming to enhance clinical appropriateness, transparency, and cost-efficiency. While biosimilars offer a high-value alternative to originator biologics, their adoption in the private sector remains variable in the absence of a dedicated biosimilar prescribing or substitution policy. This study provides a real-world analysis of biologics and biosimilars utilization and spending patterns in the private insurance market, assessing the potential alignment with CHI policy objectives and Vision 2030.
METHODS: Anonymized claims data from the NPHIES platform (2023-2024) representing the private insurance sector were analyzed. The study population included patients prescribed biologics. Key indicators assessed included total spending, biosimilar uptake, initiation patterns, and switching dynamics, with descriptive statistics conducted across therapeutic areas.
RESULTS: Biologic drugs accounted for approximately 18% of total pharmaceutical spending in Saudi Arabia’s private healthcare sector. Biosimilars demonstrated significantly faster growth than originators, with utilization increasing by 77% and spending by nearly 87%, compared to 25% and 47% growth, respectively, for originators. Despite originators dominating overall utilization and spending shares, biosimilars achieved notable market penetration, with utilization rising from 16% to 25% and spending increasing from 14% to 20%. Although switching from originators to biosimilars remained limited, biosimilar initiation among treatment-naïve patients reached up to 90% in some molecules, reflecting strong prescriber confidence and alignment with INN-based prescribing policy goals.
CONCLUSIONS: In the context of CHI-led reforms and Saudi Arabia’s broader healthcare transformation, these findings underscore the value of leveraging INN prescribing frameworks to encourage biosimilar uptake. An explicit Guidance Document on Biosimilars for the Private Sector is being developed, and this analysis provides timely evidence towards sustainable and value-based access in the private sector.