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The level of biosimilars competition in Europe varies

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Patient use of biologicals has generally increased following the introduction of biosimilars. Despite this, levels of competition in Europe are variable across molecules and countries, see Table 1, Murray Aitken explained at the 17th Biosimilar Medicines Conference [1].

Infliximab has one of the highest levels of competition in Europe. The first infliximab biosimilars, Inflectra/Remsima, were approved in the European Union (EU) back in September 2013 and there are now four infliximab biosimilars approved in Europe [2].

Trastuzumab, on the other hand, has one of the lowest levels of competition in Europe. Although there are now five trastuzumab biosimilars approved in the EU, the first trastuzumab biosimilar, Ontruzant, was only approved in November 2017 [2], perhaps explaining the low penetration as yet.

Some countries, such as Poland, have also managed to achieve high levels of biosimilar penetration. Although in Poland automatic substitution at the pharmacy level is not recommended, lack of specific guidance or laws has made it possible to occur [3].

Given the huge potential savings to be made, policies to encourage the use of biosimilars are essential for the future sustainability of the biosimilars market.

Conflict of interest
The author of the presentation [1] did not provide any conflict of interest statement.

Challenges for biosimilar sustainability in Europe

References
1. Aitken M. Advancing long-term biosimilar sustainability in Europe: the challenges ahead. Medicines for Europe 17th Biosimilar Medicines Conference; 28-29 March 2019; Amsterdam, The Netherlands.
2. GaBI Online - Generics and Biosimilars Initiative. Biosimilars approved in Europe [www.gabionline.net]. Mol, Belgium: Pro Pharma Communications International; [cited 2019 May 24]. Available from: www.gabionline.net/Biosimilars/General/Biosimilars-approved-in-Europe
3. GaBI Online - Generics and Biosimilars Initiative. Saving money in the European healthcare system with biosimilars [www.gabionline.net]. Mol, Belgium: Pro Pharma Communications International; [cited 2019 May 24]. Available from: www.gabionline.net/Biosimilars/Research/Saving-money-in-the-European-healthcare-system-with-biosimilars

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