Use of biosimilars generates savings in the Spanish health budget of 2021

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It is estimated that the national health system (Sistema Nacional de Salud, SNS) will be able to save €930 million due to the use of biosimilars in 2021, according to the results of the Budgetary Impact Analysis of Biosimilar Medicines in the SNS of Spain (2009–2022) [1].

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This study [1] is the first budget impact analysis that estimates the retrospective and prospective savings in the Spanish healthcare system, for the total marketed active ingredients of biosimilar drugs that have or will have biosimilars, taking into account the actual procurement scenario including possible commercial discounts.

As a novelty, the calculation of savings in the aforementioned report takes into account all discounts that can affect the price of the drug, including commercial discounts. Thus, it has been assumed that this scenario is closer to the price that the SNS pays for drugs, which is why it has been considered the most reliable reference model.

Among the molecules contributing most to the budgetary impact, infliximab and adalimumab stand out, the latter being responsible for more than a quarter of the total expected savings in 2021. Followed by somatropin and epoetin (alpha and zeta) despite its long history in the market. See Table 1 for the budgetary impact of each of the molecules according to the prospective study of the 2009–2022 period.

Table 1: Savings to the SNS that would be provided by each of the active ingredients with biosimilars in Spain (2009–2022) (M€)
Principio activo 2020 2021 2022 2020–2022
Adalimimab 255.3 262.3 270.7 788.3
Bevacizumab* - 23.6 48.6 72.2
Condroitina sulfato 4.8 4.8 4.8 14.4
Eculizumab** - - 18.5 18.5
Enoxaparina 7.1 7.7 8.3 23.1
Epoetinas 120.4 127.7 134.9 383.0
Etanercept 48.0 49.8 51.6 149.4
Filgrastrim 39.0 37.7 36.4 113.1
Folitropina alfa 11.0 11.2 11.4 33.5
Infliximab 152.6 165.8 179.6 498.0
Insulina glargina 38.5 40.8 43.1 122.3
Pegfilgrastim 8.9 8.9 9.0 26.8
Ranibizumab** - - 23.5 23.5
Rituximab 71.2 70.9 71.3 213.4
Somatotropina 82.6 88.9 95.3 266.8
Teriparatida 0.4 2.5 2.5 5.3
Trastuzumab 32.2 34.7 37.7 104.6
Total (M€) 2275.3 913.4 1024.2 2856
*Results are incorporated in January 2021; **February 2022.

For the 2020–2022 period, it is estimated that savings will reach €2,856 million, both from the savings that biosimilars currently on the market will continue to produce, as well as those associated with the introduction of new biosimilars. In just three years, adalimumab individually accumulates more than a quarter of global prospective savings.

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1. BioSim. Análisis de impacto presupuestario de los medicamentos biosimilares en el Sistema Nacional de Salud de España (2009-2022) [homepage on the Internet]. [cited 2021 Jul 30]. Available from:

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