Daniela Di Giuseppe1, Thomas Frisell1, Sofia Ernestam2, Helena Forsblad-D'Elia3, Elisabet Lindqvist4, Ulf Lindström5, Christopher Sjöwall6, Johan Askling1,2. 1. a Clinical Epidemiology unit, Department of Medicine Solna , Karolinska Institutet , Stockholm , Sweden. 2. b Department of Rheumatology , Karolinska University Hospital , Stockholm , Sweden. 3. c Department of Public Health and Clinical Medicine, Rheumatology , Umeå University , Umeå , Sweden. 4. d Section of Rheumatology , IKVL, Lund University and Skåne University hospital , Lund , Sweden. 5. e Rheumatology and Inflammation Research, Sahlgrenska Academy , Gothenburg University , Gothenburg , Sweden. 6. f Rheumatology/Division of Neuro and Inflammation Sciences, Department of Clinical and Experimental Medicine , Linköping University , Linköping , Sweden.
Abstract
BACKGROUND: To describe the uptake and system-level effects of the introduction of biosimilars in a setting without forced switching. RESEARCH DESIGN AND METHODS: We used data from the Swedish Rheumatology Quality register from start of marketing of infliximab (Remsima® and Inflectra®) and etanercept (Benepali®) biosimilars until 31 December 2016. We compared users of each originator-product and its biosimilar(s) by line of treatment: bDMARD-naïve patients, non-medical switchers (vs. matched patients remaining on originator), and patients switching from a previous bDMARD of another type. RESULTS: From the start of marketing 1343 patients started an infliximab biosimilar (22 months) and 2691 started etanercept (9 months). Overall, the introduction of these biosimilars resulted in an increase of the total number of ongoing infliximab and etanercept treatments (originator + biosimilar) . At the end of the study period, biosimilars accounted for 31% of all infliximab treatments and 31% of all etanercept-treated patients. For each line of therapy, we noted only small differences in patient characteristics between those starting the originator product vs. its biosimilar(s). CONCLUSIONS: Introduction of biosimilars have effects beyond replacement of the originator product, in terms of an increased rate of bDMARD initiation. Selection to non-medical switching displayed no particular disease- or patient-characteristics.
BACKGROUND: To describe the uptake and system-level effects of the introduction of biosimilars in a setting without forced switching. RESEARCH DESIGN AND METHODS: We used data from the Swedish Rheumatology Quality register from start of marketing of infliximab (Remsima® and Inflectra®) and etanercept (Benepali®) biosimilars until 31 December 2016. We compared users of each originator-product and its biosimilar(s) by line of treatment: bDMARD-naïve patients, non-medical switchers (vs. matched patients remaining on originator), and patients switching from a previous bDMARD of another type. RESULTS: From the start of marketing 1343 patients started an infliximab biosimilar (22 months) and 2691 started etanercept (9 months). Overall, the introduction of these biosimilars resulted in an increase of the total number of ongoing infliximab and etanercept treatments (originator + biosimilar) . At the end of the study period, biosimilars accounted for 31% of all infliximab treatments and 31% of all etanercept-treated patients. For each line of therapy, we noted only small differences in patient characteristics between those starting the originator product vs. its biosimilar(s). CONCLUSIONS: Introduction of biosimilars have effects beyond replacement of the originator product, in terms of an increased rate of bDMARD initiation. Selection to non-medical switching displayed no particular disease- or patient-characteristics.
Authors: Ulf Lindström; Bente Glintborg; Daniela Di Giuseppe; Dan Nordström; Sella Aarrestad Provan; Bjorn Gudbjornsson; Johan Askling; Merete Lund Hetland; Kalle Aaltonen; Niels Steen Krogh; Arni Jon Geirsson; Lennart T H Jacobsson Journal: RMD Open Date: 2019-10-23
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