OBJECTIVES:

The pressure to provide consistent, high-quality care for conditions such as wet age-related macular degeneration (AMD) across the National Health Service (NHS) is limited by key capacity issues. Challenges include clinical space, staffing, equipment, support and quality, and funding. This study aims to calculate savings generated from the switch of the reference ranibizumab molecule, to a ranibizumab biosimilar, and explore how savings could be reinvested.

METHODS:

A national budget impact model was developed to forecast the financial impact of switching from the incumbent molecule over a period of 12 months for 265,597 units (annual NHS usage Apr 21- Mar 22). Three potential discount scenarios (10%, 20% and 30% off list price) and four uptake scenarios were modelled (30%, 60%, 80% and 100% uptake) for the biosimilar. Patient access scheme price of the reference biologic and cost of switching were not considered. Secondary research was used to identify nurse salary bands from NHS resources.

RESULTS:

Switching from a reference ranibizumab to a biosimilar resulted in cost-savings across all discount and uptake scenarios after 12 months. Cost differences ranged from a minimum of £2,195,159 at the 10% discount and 30% uptake scenario, up to a maximum of £49,023,894 at the 30% off list price and 100% uptake scenario. Salaries for highly qualified nurses in NHS England start at £41,659 (entry at Band 7) and reaches a top point of £54,619 (top step point at Band 8a). Annual cost-savings could fund the employment of 40 (minimum) to 897 (maximum) additional highly qualified nurses.

CONCLUSIONS:

Cost savings generated could be reinvested to address local capacity pressures faced across NHS England in the provision of wet AMD care (e.g. recruitment of nursing staff). Overcoming these challenges could facilitate meeting commissioning recommendations in the reduction in unwarranted variation, maintenance of clinical choice and making best use of NHS resources.