OBJECTIVES: Anti-TNFs are the most commonly prescribed biologics in rheumatologic, gastroenterological and dermatological immune diseases in Ireland. The biosimilars’ introduction as a treatment option provides an opportunity to achieve cost savings within the healthcare environment. Ireland has the second worst record for biosimilar uptake within Europe. To counteract this a national biosimilar policy is to be implemented¹. The study objective was to assess the possible budget impact of introducing adalimumab biosimilars within Ireland, for all licensed adult adalimumab indications.

METHODS: A budget-impact model was used to estimate the cost saving potential of introducing an adalimumab biosimilar vs the adalimumab reference product, in Ireland over a 6- and 12-month time horizon from the regional payer’s perspective. Current adalimumab treated population has been estimated through IMS sales data and the population was assumed to remain constant during the 12-month horizon.

A scenario was developed with an adalimumab biosimilar adoption of 80% at 6 and 12 months with discounts at currently recognised levels. List prices for the reference biologic were obtained from published sources. An average nurse salary was assumed to be mid-point of a senior nurse on current payscales.

RESULTS: Introduction of an adalimumab biosimilar into the biologic treatment setting in Ireland resulted in projected budget savings over the 6 and 12-month time horizons of €45.8 and €42.5m respectively in the modelled scenarios. This could generate savings equivalent to an additional 3,100 and 3,000 patient-years of adalimumab treatment or equivalent to salaries of an additional 1,100 and 1050 nurses respectively.

CONCLUSIONS: The introduction of adalimumab biosimilars represents substantial cost-saving opportunities for the Irish healthcare system. Regional policies toward biosimilars influence their adoption thus impacting saving potential. Collaborative (e.g. gain-sharing) agreement at regional levels between the Health Service Executive and prescribers may create more cost-efficient use of medicines whilst releasing investment opportunities to enhance care pathways.