Millions of Pounds to be saved in NHS with introduction of Adalimumab biosimilars

Published: 15 Oct 2018

The first biosimilars to be introduced in rheumatology came to the UK market in early 2015, however, their use in rheumatoid arthritis is set to soar with the introduction of 4 biosimilars when Adalimumab comes off patent on 16th October, 2018.

Ailsa Bosworth, CEO of NRAS, and Clare Jacklin, Director of External Affairs, have been working with NHS England on their Adalimumab Patient Working Group with other patient organisations representing immune mediated inflammatory diseases, including Rheumatoid Arthritis, Axial Spondyloarthopathies, Psoriasis, Psoriatic Arthritis and Crohn’s & Colitis. We and NHSE wanted to ensure that issues which matter and are important to patients in regard to switching from an originator drug to its biosimilar, are understood and taken into account by CCGs and Hospital Trusts across England and Wales.

Our 4 organisations (NRAS, Crohn's & Colitis UKPsoriasis Association and NASS) provided the following quote in respect of the NHSE Press Release out today:

We welcome increased availability of effective treatment options for patients and understand the importance of the wise and careful use of NHS resources. Our organisations have been working in the field of biosimilars to provide patient information and support since 2014 and are familiar with the evidence to date which reinforces the fact that biosimilars are as safe and effective as the reference products. The introduction of biosimilars for adalimumab brings opportunities for both patients and the NHS. However, it is vital that patients are fully informed about all the treatment options available to them and commissioners and health professionals adopt the principles of shared decision-making. At a time when services are thinking about new contracts, we would also hope that patients’ views are proactively sought and that things that matter to patients, including excipients, device and homecare packages, are given due consideration.”

NHSE have announced that the biosimilar versions of Adalimumab are expected to be available to NHS patients with effect from December this year and are anticipated to bring additional savings of at least £150M per year by 2021, depending on the price agreed for the drugs. They also state that ‘the ongoing use of Humira® may also continue where clinically appropriate and where it is best value.’

It is important that where Rheumatology Units are planning for switching programmes that they include patients in stakeholder discussions to ensure that issues which matter to patients are properly taken into consideration, as part of a shared decision-making process, as reinforced in our above joint quotation.

We would also like to see that an appropriate share of savings made come back to the rheumatology department to improve service and patient care. NHS England have said that more patients are getting access to high-quality, effective care due to ‘excellent uptake of existing biosimilars’, however whilst this may be true in some therapeutic areas, it is not the case in Rheumatoid Arthritis, where the NICE eligibility criteria to access biolgics/biosimilars, has remained the same for the last 17 years and is now out of date by comparison to access to such medcines across many other European countries. NRAS are seeking discussions with NICE in partnership with the British Society for Rheumatology to address this situation and ensure that those who are not doing well on standard therapy get access to biologic and biosimilar medication where needed to improve long term outcomes.

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