Prm42 - Cost Model of Switching From Enbrel to Etanercept Biosimilars, for Non Medical Reasons, in Rheumatoid Arthritis Patients in Spain

Peral, Carmen; Valderrama, M.; Montoro, María; Gómez, Susana; Tarallo, M.

doi:10.1016/j.jval.2018.09.2165

Cited by 2 publications

(9 citation statements)

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“…€1227.75 [$C1904], ? 12.0%) in comparison to those remaining on the reference biologic to treat RA [37]. These results were corroborated by the findings of Tarallo et al (2019), who published results of a physician survey of 1259 patients with RA who switched from etanercept to the biosimilar [32].…”

Section: Non-medical Switching-related Costssupporting

confidence: 53%

“…Among them, 13 studies investigated gastroenterology patients, 15 investigated rheumatology, three investigated unspecified or multiple disease areas, and there was one study each on dermatology and growth development. The majority of these studies reported on the savings associated with drug costs alone or the overall savings following NMS without specifying the inputs used for the calculations; however, four of these studies reported on the difference in costs between patients pre- and post-switch ( n = 1) or between patients who switched and those who remained on the reference biologic (i.e., switchers and non-switchers, respectively, n = 3) [ 32 , 35 – 37 ].…”

Section: Resultsmentioning

confidence: 99%

“…While these studies were scarce, they provided a better understanding of the savings or costs that were associated with the switch from the reference biologic to the biosimilar drug. Specifically, three studies reported on HCRU differences [6,33,34], three studies reported on cost differences [35][36][37], and one study reported on differences in both HCRU and overall costs [32]. With regards to HCRU, all studies concluded that NMS was associated with a significant or numerical increase in HCRU among patients who underwent originator-tobiosimilar NMS [6,[32][33][34].…”

Section: Discussionmentioning

confidence: 99%

“…With regards to HCRU, all studies concluded that NMS was associated with a significant or numerical increase in HCRU among patients who underwent originator-tobiosimilar NMS [6,[32][33][34]. Interestingly, there was a notable difference between studies in terms of outpatient visits associated with NMS, where this was greater for the study by Tarallo et 2017) found that a NMS from originator etanercept or infliximab to the biosimilar in rheumatic patients generated an overall increase in total costs to patients in comparison to remaining on the originator (p = 0.046 in Phillips (2017), unreported in Peral (2018) and Tarallo (2019)) [32,36,37]. Importantly, Tarallo et al identified blood and imaging tests, emergency visits, hospitalizations, and visits with various specialists as the primary healthcare costs leading to the increase in total patient costs following NMS [32].…”

Section: Discussionmentioning

confidence: 99%

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The Economic Impact of Originator-to-Biosimilar Non-medical Switching in the Real-World Setting: A Systematic Literature Review

Hillhouse¹,

Mathurin

Parison

et al. 2021

Adv Ther

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Introduction To save costs to the healthcare system, forced non-medical switch (NMS) policies that cut drug coverage for originator biologics and fund only less expensive biosimilars are being implemented. However, costs related to the impact of NMS on healthcare resource utilization (HCRU) must also be considered. This study aims to summarize the evidence on the economic impact of an originator-to-biosimilar NMS. Methods A systematic literature review (SLR) was conducted. Publications reporting on HCRU or costs associated with originator-to-biosimilar NMS in the real-world setting were searched in MEDLINE and EMBASE from January 2008 to February 2020. In addition to hand searching the reference lists of relevant publications and SLRs, key conference websites, PubMed, and various government sites were also searched for the 2 years preceding the search (2018–2020). Results A total of 1845 citations were identified, of which 49 were retained for data extraction. Most studies reporting on the HCRU associated with NMS reported on post-NMS HCRU alone without a comparison pre-NMS. However, four studies described a difference in HCRU (i.e., investigations pre- vs post-switch or between non-switchers vs switchers), all of which reported a relative increase in HCRU, including laboratory testing, imaging, medical visits, and hospitalizations, amongst patients who underwent an originator-to-biosimilar NMS. Most studies reporting on the costs associated with NMS reported significant savings following NMS on the basis of drug costs alone. However, four studies specifically reporting on the difference of costs following originator-to-biosimilar NMS all demonstrated an increase in HCRU-related costs associated with NMS (increase in HCRU-related costs of 4–37% or 148–2234 2020 Canadian dollars). Conclusion Amongst the studies that reported on the difference in HCRU pre- vs post-switch or between non-switchers and switchers, all showed an increase in HCRU and related costs associated with NMS, suggesting that the expected overall savings due to less costly drug prices may be reduced as a result of an increase in HCRU and its associated costs post-switch. Nevertheless, more real-world studies that include NMS-related healthcare costs in addition to drug costs are needed. Supplementary Information The online version contains supplementary material available at 10.1007/s12325-021-01951-z.

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Section: Non-medical Switching-related Costssupporting

confidence: 53%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

The Economic Impact of Originator-to-Biosimilar Non-medical Switching in the Real-World Setting: A Systematic Literature Review

Hillhouse¹,

Mathurin

Parison

et al. 2021

Adv Ther

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“…Clair Jones 2017 [31]IBD (CD and UC)Center-based cohort studyBiosimilar infliximab6 monthsHospital dataOf switch patients, 11.3 percent experienced dose escalation and a payment was negotiated to fund the switchSzlumper 2017 [19]RheumatologyCenter-based cohort studyBiosimilar etanercept7 monthsBiologic registryThree switchers requested face-to-face consultations on use of delivery device; all potential switchers were invited to face-to-face switching clinic with specialist pharmacist and nurseBarnes 2018 [23]RA, AS, PAInterviewBiosimilar etanerceptNRInterviewStaff spent 320–1076 additional hours on the non-medical switch across the four centersGlintborg 2018 [17]RA, PA, ASRegistry/National databaseBiosimilar infliximab1 yearDANBIO, Danish National Patient RegistryThe included patients had 39 more outpatient visits within 6 months after the switch than beforeTotal days with services were 4131 before (mean 5.4 days, SD 2.8) and 4400 after switch (mean 5.8 days, SD 2.8) ( p < 0.01, paired t test). After the switch, 259 patients (34%) had fewer (mean − 2.4, SD 1.7), 169 patients (22%) had the same and 341 patients (45%) (mean 2.6, SD 2.0) had more days with services than before switchPatients on average had more phone consultation (1.17 vs. 1.03, p = 0.03), patient guidance (0.49 vs. 0.35, p < 0.01), intravenous medication (0.11 vs. 0.03, p < 0.01), clinical investigation (0.47 vs. 0.31, p < 0.01), clinical control (2.26 vs. 2.08, p < 0.01) and observation (0.22 vs. 0.17, p < 0.01) within 6 months after switchNisar 2018 [27]RACenter-based cohort studyBiosimilar rituximab1 yearHospital dataTwo patients (8%) experienced emergency department visits after switching5 (20%) had severe serum sickness reaction within the 1st week of the second dose and lost responseFour (17%) requested to return to the originatorPeral 2018 [20]RASimulation studyBiosimilar etanercept1 yearDANBIO registry, survey of 30 rheumatologists in SpainThe non-medical switch is associated with treatment adjustment costs, including monitoring, hospitalization and othe...…”

Section: Methodsmentioning

confidence: 99%

Economic Impact of Non-Medical Switching from Originator Biologics to Biosimilars: A Systematic Literature Review

et al. 2019

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IntroductionA systematic literature review was conducted to review and summarize the economic impact of non-medical switching (NMS) from biologic originators to their biosimilars (i.e., switching a patient’s medication for reasons irrelevant to the patient’s health).MethodsEnglish publications reporting healthcare resource utilization (HRU) or costs associated with biosimilar NMS were searched in PubMed and EMBASE over the past 10 years and from selected scientific conferences over the past 3 years, along with gray literature for all biologics with an approved biosimilar (e.g., tumor-necrosis factor inhibitors, erythropoiesis-stimulating agents, insulin and hormone therapies).ResultsA total of 1311 publications were retrieved, where 54 studies met the selection criteria. Seventeen studies reported increased real-world HRU or costs related to biosimilar NMS, e.g., higher rates of surgery (11%), steroid use (13%) and biosimilar dose escalating (6–35.4%). Among the studies that the estimated cost impact associated with NMS, 33 reported drug costs reduction, 12 reported healthcare costs post-NMS without a detailed breakdown, and 5 reported NMS setup and managing costs. Cost estimation/simulation studies demonstrated the cost reduction associated with NMS. However, variation across studies was substantial because of heterogeneity in study designs and assumptions (e.g., disease areas, scenarios of drug price discount rates, cost components, population size, study period, etc.).ConclusionReal-world studies reporting the economic impact of biosimilar NMS separately from drug costs are emerging, and those that reported such results found increased HRU in patients with biosimilar NMS. Studies of cost estimation have been largely limited to drug prices. Comprehensive evaluation of the economic impact of NMS should incorporate all important elements of healthcare service needs such as drug price, biologic rebates, HRU, NMS program setup, administration and monitoring costs.FundingAbbVie.Electronic Supplementary MaterialThe online version of this article (10.1007/s12325-019-00998-3) contains supplementary material, which is available to authorized users.

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Prm42 - Cost Model of Switching From Enbrel to Etanercept Biosimilars, for Non Medical Reasons, in Rheumatoid Arthritis Patients in Spain

Cited by 2 publications

References 0 publications

The Economic Impact of Originator-to-Biosimilar Non-medical Switching in the Real-World Setting: A Systematic Literature Review

The Economic Impact of Originator-to-Biosimilar Non-medical Switching in the Real-World Setting: A Systematic Literature Review

Economic Impact of Non-Medical Switching from Originator Biologics to Biosimilars: A Systematic Literature Review

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