OBJECTIVES

: Humira^® European patent expires in October 2018. Humira^® is an attractive product for biosimilars due to its blockbuster status. It is the highest spend drug in UK NHS hospitals: £250 million in 2015/2016. In 2017, four adalimumab biosimilars were approved by the EMA. The UK has introduced aggressive targets to encourage biosimilar uptake and generate savings. Specialised services have a goal of treating 90% of new patients with best value biologic within 3 months of launch and 80% of existing patients within 12 months. We studied whether it is more beneficial to reinvest adalimumab biosimilar savings to treat additional RA patients or spend it on alternative treatments from a UK payer perspective.

METHODS

: Firstly, a model estimated the savings from adalimumab biosimilars from a UK NHS perspective. Secondly, five alternative indications were selected based on burden of illness and associated high-cost but high-efficacy treatments: melanoma, hepatitis C (HepC), multiple sclerosis (MS), Duchenne’s disease (MD), and non-small cell lung cancer (NSCLC) with the treatments: ataluren (MD), natalizumab (MS), pembrolizumab (melanoma), crizotinib (NSCLC), and sofosbuvir+ ribavirin (HepC). The model estimated the health gain (expressed as QALYs) that could be obtained from using the adalimumab biosimilar savings to treat patients in the five alternative indications and RA.

RESULTS

: We estimated savings from adalimumab biosimilar of ~£10 million over five years (2018-2022). We implemented a conservative approach on biosimilar uptake (68% in the third year) and we expect the savings to exceed this mark, up to £14 million (with 92% market share in the third year). Considering the average QALYs gains, biosimilar savings are best spent on Hep C (654) treatments followed by RA (367), MS (300), NSCLC (248), melanoma (85) and MD (17).

CONCLUSIONS

: Our research highlights that payers should also consider other options to reinvest biosimilar savings in disease areas with high QALY yields.