Since the first approval of a biosimilar medicine in the EU in 2006, the promise of biosimilars has been to facilitate greater patient access to biologic medicines, thus improving population health outcomes. Indeed, it has been shown that the entrance of biosimilars into a therapeutic space increases price competition, thus driving down the price. Between 2016 and 2020, the addressable biosimilars market (i.e. biologics losing patent protection) in the EU5 and US has been estimated at €47bn, of which the UK accounts for €9bn. Compared with generic medicines the introduction of biosimilar medicines has proven more complicated, despite a shared potential for pharmaceutical savings in a health service facing substantial funding challenges. Studies and reports identified between 2010 and 2018 have discussed the perceived slow uptake of biosimilars in the UK. These have ranged from physician concern over biosimilar efficacy/safety to a lack of consistent information from manufacturers and across stakeholders within the NHS. In September 2017 the NHS released the Commissioning framework for biological medicines, a guideline on the use of biologic and biosimilar medicines. The aim this was to build upon previous guidance from NICE to “improve clinician confidence and clarify understanding amongst decision makers”. It is expected that this evolving attitude to biosimilar medicines use will lead to increased usage, potentially facilitating pharmaceutical savings of ~£300 million per years across the NHS. There is evidence to suggest that this more active leadership role is already leading to increased patient access to biologic medicines.