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

Healthcare resource utilization (HRU) increases in patients with non-medical switching (NMS) from biologic originators to their biosimilars, according to a systematic literature review published in Advances in Therapy.

The researchers examined 1,311 publications reporting HRU or costs associated with biosimilars NMS from PubMed and EMBASE databases from January 2008 to September 2018. They also evaluated literature from various scientific conferences that occurred in last three years, as well as gray literature for all biologics accompanied with an approved biosimilar (i.e., tumor-necrosis factor inhibitors). Search terms included “biosimilar,” “biosimilar agent,” “health resources,” “resource utilization,” and “health care costs.” Following a two-level literature screening process, data extraction was performed by two reviewers to ensure accuracy.

According to the findings of their review, 17 studies reported increased real-world HRU or costs related to biosimilar NMS, including: augmented rates of surgery (11%), steroid use (13%) and biosimilar dose escalating (6–35.4%). Moreover, the results indicated that with respect to 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. Overall, cost estimation studies exhibited that cost reduction was associated with NMS. However, results significantly varied across studies because of the diversity in study designs and assumptions (i.e., disease areas, population size, study period, etc.).

“The future concerning originators vs. biosimilars continues evolving and requires close monitoring of this dynamic field,” the review authors wrote. “With a focus on the economic impact such as HRU and costs over the past 10 years, this systematic literature review found that the overall economic impact of biosimilar NMS remains uncertain.”

The authors concluded by writing that in particular, a “better understanding the upfront costs required to prepare patients and prescribers for biosimilar NMS to manage the expectations (e.g., patient education and support, trainings to healthcare professionals) can be important, which may help mitigate the potential consequences associated with biosimilar NMS. Collectively, this information would allow payers, physicians and policy makers to more comprehensively assess the implications of biosimilar NMS.”

Read more at Advances in Therapy