by Thomas Meek at Medicines for Europe's biosimilars conference
LONDON, May 2 (APM) - Norway, Denmark and Finland have achieved a near total switch to biosimilar versions of Janssen’s Remicade (infliximab).
The Scandinavian countries are much further ahead than other European countries when it comes to switching to copies of the originator drug, which lost patent in Europe in early 2015, allowing Celltrion and Hospira to launch their versions, IMS Health’s Per Troein told a conference on Thursday.
Speaking at Medicines for Europe’s biosimilars meeting in London, Troein said that the lower-priced biosimilars - clinically equivalent versions of biological medicines that have lost patent protection - had impacted the overall preferred choice of anti-TNF in Norway, Denmark and Finland, with biosimilar infliximab taking a substantial market share in these countries from other rivals in the same class.
Other anti-TNFs, which are available for a variety of immunological disorders such as Crohn’s disease and rheumatoid arthritis, include AbbVie’s Humira (adalimumab) and Janssen’s Simponi (golimumab).
He said: “When you get a drastically lower price, and in this case we are talking two-thirds down, it is actually changing what products patients are initiated on.”
There are several reasons for this strong uptake in the Nordic countries, said Troein, including “strong national champions” in Norway and Denmark that are driving the issue.
“They have a natural process for endorsement and that process has a board engaged in discussion with the prescribing doctors. And they have national tenders that react very fast.”
He added that the economic benefit of switching to a cheaper biosimilar for hospitals in these countries goes back into the organisations, further influencing their decision.
In Sweden and the UK the uptake of biosimilar Remicade has not been as strong, due in part to the varied healthcare systems of each country.
Troein said, for example, that Sweden has 21 country councils and each of these has to take a view on how to carry out treatment-switching. He said that three councils have gone the way of Denmark, but the rest are still only at a trial stage for switching.
In the UK, he said that a number of National Health Service (NHS) trusts had totally switched, but the majority had done “very little”.
One English NHS trust to encourage switching is University Hospital Southampton NHS Foundation Trust, which has switched all of its gastroenterology patients who were on Remicade to a biosimilar version in order to save money.
Fraser Cummings, consultant gastroenterologist at University Hospital Southampton, said the move was saving the trust up to 80,000 pounds (102,000 euros) per month.
Speaking in a separate presentation at the Medicines for Europe event, Bjorn Gulbrandsen, a member of Norwegian IBD patient organisation LMF, said there were “three things” that meant his country was able to switch to biosimilar Remicade so effectively: “Information, information, information".
He added that this must be information from different sources with a balanced view that takes scientific background into account.
Steinar Madsen, medical director of the Department of Drug Information of the Norwegian Medicines Agency, agreed that information was key.
“The main source of information to patients is doctors. So we concentrated on working with doctors. We had some doctors that took up the question really early and I think that was very important.”
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