Infliximab biosimilars are safe, effective, and cheap, UK audit shows

White, Caroline

doi:10.1136/bmj.i5084

Cited by 5 publications

(5 citation statements)

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“…Analysis of subsequent years after market stabilization of biologics and biosimilars in the U.S. may reveal similar cost reductions for originator biologics previously reported in European countries with increasing biosimilar use. 26 …”

Section: Discussionmentioning

confidence: 99%

“…13 Although outside the scope of this study, proactive out-patient IBD care with the treatment goal of cor- reductions for originator biologics previously reported in European countries with increasing biosimilar use. 23 In summary, our analysis uniquely explores the cost impact of increasing biologics use from out-patient IBD care in the USA. The findings from our study further reiterate the ongoing need to develop patient-centred, cost-effective pharmacotherapy strategies by judiciously incorporating biologics in individualized therapy plans.…”

Section: Discussionmentioning

confidence: 99%

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Market share and costs of biologic therapies for inflammatory bowel disease in the USA

MacIsaac

Wong

et al. 2017

Aliment Pharmacol Ther

157

106

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Market share and costs of biologic therapies for inflammatory bowel disease in the USA

MacIsaac

Wong

et al. 2017

Aliment Pharmacol Ther

157

106

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“…48 Biosimilars have been reported to be as safe and effective as originators. 49 Hence, there has been a drastic overall reduction in the annual cost per patient in managing diseases without any compromise in efficacy. This brings into question whether treatment withdrawal in patients who have achieved remission is a sound strategy.…”

Section: Discussionmentioning

confidence: 99%

Clinical outcomes, predictors of prognosis and health economics consequences in IBD patients after discontinuation of the first biological therapy

Shivaji

Bazarova²,

Critchlow

et al. 2020

Therap Adv Gastroenterol

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Background: In real-world clinical practice, biologics in inflammatory bowel diseases (IBD) may be discontinued for a variety of reasons, including discontinuation initiated by gastroenterologists. The aims of the study are to report outcomes after discontinuation and predictors of prognosis after a minimum follow-up of 24 months; outcomes of gastroenterologist-initiated discontinuation with resulting direct cost implications on the health system were also studied. Methods: IBD patients who discontinued their first-use biologics between January 2013 and December 2016 were identified at our tertiary centre. Reasons for discontinuation and pre-defined adverse outcomes (AO) were recorded. Data were analysed using univariable and multivariable logistic regressions within a machine learning technique to predict AO. Gastroenterologist-initiated discontinuations were analysed separately, and Kaplan–Meier survival analysis performed; direct costs of AO due to discontinuation were assessed. Results: A total of 147 patients discontinued biologics (M = 74; median age 39 years; Crohn’s Disease = 110) with median follow-up of 40 months (range 24–60 months). In the total cohort, there were fewer AO among gastroenterologist-initiated discontinuations compared with patient-initiated; 54% (of the total group) had AO within 6 months. Among 59 gastroenterologist-initiated discontinuations, 23 (40%) had IBD-related AO within 6 months and 53 (90%) patients had AO by end of follow-up. Some 44 (75%) patients needed to restart biologics during follow-up, and direct costs due to AO and restart of biologics were high. Conclusions: The proportion of patients who have AO following discontinuation of biologics is high; clinicians need to carefully consider predictors of poor prognosis and high relapse rates when discussing discontinuation. The direct costs of managing AO probably offset theoretical economic gains, especially in the era where cost of biologics is reducing. Biologics should probably be continued without interruptions in most patients who have achieved remission for the duration these remain effective and safe.

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“…For IBD, the UK Royal College of Physicians' annual audit of biologics suggested that the introduction of biosimilar infliximab could half the annual cost of treatment [43]. This would save the health services an estimated £90 million per year if all patients were switched to a biosimilar [44].…”

Section: Opportunities From Biosimilarsmentioning

confidence: 99%

Biosimilars: From Extrapolation into Off Label Use

Zhao

Nair

Moots

2018

CPD

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Biosimilars offer many potential opportunities in improving treatment access and increasing treatment options. The high cost associated with marketing approval means that many bio-originators may never become licenced for rarer inflammatory conditions, despite clinical efficacy. Biosimilars, with lower acquisition cost, may improve access for off-label use of biologics in the management of these patients. They may also provide opportunities to explore off-label treatment of conditions where biologic therapy is less established. However, this potential advantage must be balanced with the awareness that off-label prescribing can potentially expose patients to risky and ineffective treatments. Post-marketing surveillance is critical to developing long-term evidence to provide assurances on efficacy as well as safety.

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Infliximab biosimilars are safe, effective, and cheap, UK audit shows

Cited by 5 publications

References 0 publications

Market share and costs of biologic therapies for inflammatory bowel disease in the USA

Market share and costs of biologic therapies for inflammatory bowel disease in the USA

Clinical outcomes, predictors of prognosis and health economics consequences in IBD patients after discontinuation of the first biological therapy

Biosimilars: From Extrapolation into Off Label Use

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