1ISG-007 Biosimilar of infliximab: does the penetration rate meet expectations? appraisal in a central purchasing office

Background Prescription of biosimilars on a large scale is an important lever to decrease hospital expenses. As a result, 40 M€ of savings are expected in the healthcare bill by the promotion of biosimilar use in 2018. In 2015, one wholesaler (WS) listed one of the two biosimilars of infliximab. Purpose The objective of the study is to analyse the penetration rate (PR) of this biosimilar in 96 hospitals bought by this WS. Material and methods To define the PR of biosimilar, we used quantities ordered of both drugs (originator and biosimilar): data were provided by manufacturers between September 2016 to May 2017. The PR is defined as the per centage of the number of biosimilar vials purchased of the total vials of infliximab. In parallel, a survey was sent to hospitals on three items: listing of biosimilar in their formulary, prescribing care units and PR target. Results Among hospitals ordering from WS, only 38% (n=36/96) ordered infliximab. The average PR of hospitals is 30%. However, there is a high disparity between hospitals: 10 hospitals did not order the biosimilar and four hospitals ordered only the biosimilar. The response rate of the survey is 69% (25/36), with 72% referencing two molecules, 16% only the biosimilar and 12% only the originator: 68% have a rheumatology department, 92% have a gastroenterology department and 24% have a dermatology department. For the 13 hospitals setting a PR target, the range varies from 25% to 75%, with 76% (10/13) achieving it. For hospitals with 0% PR, it can be explained to some extent by the non-listing of the biosimilar (small hospitals, management hurdles) or by not following the national recommendations (initiate biosimilar in naive patients). The achievement of the PR target by only 13 hospitals shows that clinicians are still reluctant to prescribe biosimilars, a lack of consensus of national societies and an unclear regulatory framework which does not promote switching. However, the consumption of biosimilars should increase following the publication of the Nor-SWICH study, which showed the non-inferiority of biosimilars compared to the originator. Conclusion The current biosimilar PR remains low within hospitals bought through this WS, However actions can be taken to increase this rate for economic reasons. No conflict of interest