Presentation (CTI)

OBJECTIVES: To compare biosimilar procurement frameworks in Poland and Norway, countries with different population size and economic capacity, and assess how differences in procurement governance, access pathways and other aspects influence biosimilar uptake and patient access to biological therapies.
METHODS: A comparative qualitative policy analysis used materials from study visits to Poland and Norway (Apr 2026). Sources included presentations and discussions with regulators, procurement bodies, payers, clinicians, pharmacists and patient organisations, supplemented with a hospital pharmacy visit. IQVIA’s The Impact of Biosimilar Competition in Europe 2026 report was used (treatment days for infliximab, etanercept and adalimumab).
RESULTS: Poland and Norway represent distinct procurement models. Norway's small population, high GDP per capita, and consolidated hospital system enable centralised procurement linked to clinical decision making. Involvement of clinicians and patient representatives aligns tender outcomes and clinical practice. Coordinated switching policies, allows rapid and uniform implementation. As a result, biosimilars uptake appears early, fast, and consistent nationwide. In contrast, Poland has a larger population, lower GDP per capita and fragmented hospital structure. Anti-TNF biological therapies are mainly provided through national drug programmes with stricter-than-SmPC eligilibity criteria, while procurement is decentralised through multiple hospital-level tenders, primarily price-driven and more administrative. Poland achieved substantial price reductions, with working data indicating approximately −74% price reduction, 78% biosimilar share and +371% volume growth. However, treatment intensity remains low, with treatment days per capita estimated at 0.21. In Norway, price reductions appear more moderate, approximately −28%, with 83% biosimilar share and +228% volume growth, but treatment days per capita are substantially higher at 3.3.
CONCLUSIONS: Lower prices alone do not guarantee improved access. Poland represents a cost-optimisation model, but limited translation of savings into expanded access that might be constrain by eligibility criteria, whereas Norway demonstrates an access-oriented model, where coordinated procurement and clinical alignment enable increased treatment uptake.