OBJECTIVES:

Incentives policies applied to biosimilars are heterogenous across European countries. In France, a financial incentive applies from 1^st January 2018 to reward hospitals increasing prescribing rate for etanercept and insulin biosimilars dispensed in community pharmacies. This study assesses the potential cost savings and the amount of the financial incentive for different prescribing scenarios of etanercept and insulin biosimilars for the 39 Public Hospitals of Paris (AP-HP).

METHODS:

To perform the economic simulation, community pharmacy dispensing data for drugs prescribed in AP-HP in 2016 were retrieved from the open access database “Open PHMEV” (prescribing hospital, ATC classification, amount of dispensed drugs, reimbursed amount). Cost savings= [branded drug public price – biosimilar public price] X biosimilar uptake X amount of dispensed drugs; financial incentive = 20% X [branded drug public price – biosimilar public price] X biosimilar uptake X amount of dispensed drugs. Four scenarios of the biosimilar uptake were tested: 80% (French national objective 2018-2022), 70%, 50% and 40%.

RESULTS:

Dispensing data were originated from prescription of 36 AP-HP hospitals (92%). A total of 23,740 boxes of branded and biosimilar etanercept and 108,716 boxes of branded and biosimilar insulin were respectively prescribed by 21 and 36 AP-HP hospitals. With a biosimilar uptake level of 80%, cost savings were estimated to 2,801,666€ and 749,725€ respectively for etanercept and insulin biosimilars. The total amount of financial incentive was estimated to 711,185€: 80% for etanercept biosimilar (559,090€) and 20% for insulin biosimilar (152,095€).

CONCLUSIONS:

Priority actions need to be directed towards prescribing etanercept biosimilar because cost savings are higher, and the market is concentrated on a small number of hospitals. Cost savings were underestimated because prescription refills in community pharmacies were excluded. This financial incentive could be an interesting driver to increase prescribing rates of biosimilars, but education remains the cornerstone to improve biosimilar uptake.