The effect of new biosimilars in rheumatology and gastroenterology specialities on UK healthcare budgets: Results of a budget impact analysis

Background: The approval of new biosimilars of infliximab, etanercept and adalimumab by the European Medicines Agency is expected to produce further cost savings to the healthcare system budget. Objectives: This study aimed to estimate the budget impact of the introduction of new biosimilars Flixabi (R), Erelzi (R), Solymbic (R), Amgevita (R) and Imraldi (R) in rheumatology and gastroenterology specialities in the UK. Methods: A published budget impact model was adapted to estimate the expected cost savings following the entry of new biosimilars Flixabi (R), Erelzi (R), Solymbic (R), Amgevita (R) and Imraldi (R) in the UK over three-year time horizon. This model was based on retrospective market shares of biologics used in rheumatology and gastroenterology which were derived from DEFINE Software and healthcare professional perspectives. Results: The model predicted that infliximab and etanercept biosimilars would replace their corresponding reference agents by 2020. Adalimumab biosimilars were predicted to achieve 19% of the rheumatology and gastroenterology market by 2020. Without the introduction of further biosimilars, the model predicted a reduction in expenditure of pound 44 million on biologics over the next three years. With the entry of Flixabi (R), Erelzi (R), Solymbic (R), Amgevita (R) and Imraldi (R) the model estimates cumulative savings of 285 pound million by 2020. Conclusions: The introduction of new infliximab, etanercept and adalimumab biosimilars will be associated with considerable cost savings and have a substantial favourable impact on the UK NHS budget. The number of biosimilars and time of entry of is critical to create competition which will result in maximum cost savings.