OBJECTIVES

Rising hospital medicine costs are a growing concern. Especially new, patented, first in class medicines are accountable for a large part of the total medicine costs due to high pricing during the patented period. Therefore, initiatives aiming to decrease medicine costs as soon as the patents expire are crucial. A clear, effective method to achieve the possible cost-reduction at patent expiration without compromising efficacy and patient safety are explored.

METHODS

The method was tested when the patent on the originator brand of adalimumab (Humira®) expired in 2018 and biosimilar adalimumab was expected to reach the Danish market. When the patent expiration date was confirmed and the tender period planned, the hospital pharmacy and the Regional Drug Committee met with the specialists in diseases treated with adalimumab. The aim of these meetings was to discuss and align the procedure of switching from the originator product to the biosimilar product. The direct-to-patient distribution of adalimumab was fitted to the tender period end date in order to deplete the stock of the more expensive originator product. Close to the patent expiration date, the implementation was closely coordinated to implement the biosimilar switch. The method, as well as the effect on consumption and economy, were evaluated.

RESULTS

The method resulted in a significant change in consumption on Day 1, where 91% of the adalimumab consumption was of the biosimilar product. A complete switch (94%) was achieved in Week 4. Thereby, a cost-reduction of 1.1 mil EUR was reached after the first 4 weeks after implementation.

CONCLUSIONS

The developed method for use at patent expiration provides a clear, remarkably effective procedure to achieve the optimal possible cost-reduction without compromising efficacy and patient safety.