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Rituximab biosimilar CT-P10 could save Europe Euros 90 million in its first year Posted 01/09/2017

A recent publication in Advances in Therapy suggests that introducing CT-P10, a biosimilar of the anti-CD20 monoclonal antibody rituximab, would generate significant savings for European healthcare systems [1]. CT-P10 is approved by the European Medicines Agency (EMA) for all indications held by reference rituximab, including rheumatoid arthritis and haematological cancers, such as non-Hodgkin’s lymphoma and chronic lymphocytic leukaemia. Although the therapeutic benefits of anti-CD20 therapy are well established, the cost of reference rituximab is thought to create barriers to patient access [2]. It is hoped that the introduction of more affordable biosimilars will help address this issue. Gulácsi L et al. therefore quantified the potential budgetary impact of introducing CT-P10 for the treatment of rheumatoid arthritis and CD20-positive cancers in 28 European countries [1].

The budget impact model, which was developed according to good practice guidelines proposed by the International Society for Pharmacoeconomics and Outcomes Research, assumed as a base-case scenario that the cost of CT-P10 would be 70% that of reference rituximab. Assuming that CT-P10 acquires a 30% market share in its first year, the model predicts combined total healthcare savings for the 28 European countries of just over Euros 90 million. This would be enough to treat an additional 7,531 patients (including 2,857 with rheumatoid arthritis, 2,263 with non-Hodgkin’s lymphoma, 1,624 with chronic lymphocytic leukaemia, and 787 with other diagnoses).

A second scenario examined what would happen if CT-P10 were to achieve a market share of 50% in its first year. In this scenario, total projected savings would exceed Euros 150 million, and would allow more than 12,500 additional patients to be treated. Finally, Gulácsi L et al. modelled the potential budgetary impact over three years based on the assumption that CT-P10 achieves a market share of 30%, 40%, and 50% in its first, second, and third years, respectively. The total savings over this 3-year period equate to approximately Euros 570 million: enough to treat an extra 47,695 patients. 

Cost is not the only factor that determines uptake of biosimilars. The attitudes of patients, healthcare professionals and payers also play a part. Despite evidence that switching is non-inferior to continuing with the reference product [3], there is evidence that physicians may be reluctant to switch patients currently taking a reference product over to a biosimilar [4]. Providing the opportunity for physicians to directly input to the reallocation of the resulting savings appears to help counter this effect [4]. As Europe’s population ages and the incidence of disorders such as cancer and rheumatoid arthritis increases, the savings associated with uptake of biosimilars may help healthcare systems to meet the increasing demands placed upon them.

Conflict of interest
The authors of the research paper [1] reported that Celltrion Healthcare sponsored the development and analysis of the budget impact analysis model. For full details of the authors’ conflict of interest, see the research paper [1].

Abstracted by Professor Laszlo Gulácsi, Corvinus University of Budapest and HTA

Consulting Budapest, Budapest, Hungary. (medical writing support funded by Celltrion Healthcare)

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References
1. Gulácsi L, Brodszky V, Baji P, et al. The rituximab biosimilar CT-P10 in rheumatology and cancer: a budget impact analysis in 28 European countries. Adv Ther. 2017;34:1128-44.
2. Baer Ii WH, Maini A, Jacobs I. Barriers to the access and use of rituximab in patients with non-Hodgkin’s lymphoma and chronic lymphocytic leukemia: a physician survey. Pharmaceuticals (Basel). 2014;7(5):530-44.
3. Jørgensen KK, Olsen IC, Goll GL, et al. Switching from originator infliximab to biosimilar CT-P13 compared with maintained treatment with originator infliximab (NOR-SWITCH): a 52-week, randomised, double-blind, non-inferiority trial. Lancet. 2017;389(10086):2304-16.
4. Baji P, Gulacsi L, Golvics PA, et al. Perceived risks contra benefits of using biosimilar drugs in ulcerative colitis: discrete choice experiment among gastroenterologists. Value Health Reg Issues. 2016;10:85-90.

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