PBI13 TNF-ALPHA INHIBITORS IN THE CZECH REPUBLIC: HOW BIOSIMILARS AFFECT OVERALL CONSUMPTION AND COSTS?

Abstract

In the Czech Republic, a system of reference groups (RGs) is in place. A RG is a group of medicines with comparable effectiveness, safety profile and clinical use. All medicines within the same RG have the same reimbursement price per usual daily dose. When the first biosimilar product is launched, its maximum and reimbursement price are lowered by 30%. For this reason, the reimbursement price of all medicines in the RG is lowered, too. In this study, we analyzed the change in the consumption and costs of TNF-α inhibitors (TNFis) after the launch of the first biosimilar product (infliximab) in 2013. Firstly, we extracted publicly available data about medicine consumption in the Czech Republic and analyzed all annual reports from 2010 to 2018. Data for relevant medicines were sorted by active substance, type of authorization process, unit and total costs. Identified price decrements were cross-checked with data from national list of reimbursed medicines. The consumption of all TNFis has almost doubled with an 87% increase over the last 5 years. Infliximab and adalimumab are the most used substances of this RG. In 2018, biosimilars market share reached 33% of the total TNFis market. The consumption of certolizumab and golimumab has grown up more than three- and two-times respectively. Since 2017, biosimilar infliximab has been much more used than original infliximab. Between 2013 and 2018, cost per daily dose has, on average, decreased by 24%. The decrease in daily costs significantly differed among substances. The consumption of TNFi is still growing and patient access to biological treatment has been improving over time. The first launched biosimilar improved access to TNFi therapy. The lowering of unit costs over the years has been primarily caused by reassessments of this RG, price contracts between the insurance funds and the companies and market competition.