PHP356 - Adoption of Oncology Biosimilars in Europe

Abstract

Following the introduction of the anti-TNF biosimilars, infliximab and etanercept, the next wave of biosimilar products in Europe will be for oncologic diseases. Attention is now turning to biosimilar versions of monoclonal antibody (mAb) treatments such as rituximab, trastuzumab and cetuximab, and the potential cost-savings these treatments will generate for European healthcare systems. However, there are marked differences in the disease dynamics for cancer versus conditions targeted by the anti-TNFs (i.e. chronic inflammatory diseases such as rheumatoid arthritis). These differences will have important implications on the adoption rates for oncology biosimilars. The aim of this research is to explore the likely uptake of the oncology biosimilars across Europe, taking into consideration stakeholder perceptions, prescribing behavior, discounting expectations as well as policies and other payer mechanisms to incentivize adoption. To address these objectives, we ran an advisory board with leading ex-payers from France, Germany, Italy, Spain and the UK. Prescribing anti-TNF biosimilars is widely accepted in treatment-naïve patients, but opinion differs greatly with switching stable patients due to uncertainties around long-term outcomes. As shorter-term treatments, oncology biosimilars will not be subject to the same concerns. There may be initial resistance to prescribing as cancer can be life-threatening whereas inflammatory diseases are not. However, clinicians are soon likely to accept the interchangeability, whereupon all patients will be initiated on cheaper biosimilar treatments – or, with no pool of stable patients to protect, originator companies will need to reduce their prices to compete. Oncology biosimilars will likely yield greater cost-savings for European healthcare systems than those generated by the anti-TNF biosimilars. This is not simply due to larger total sales volumes with the oncologic mAbs, but also as a consequence of faster and deeper erosion of the prices and volumes with the originator products.