Prescribing biosimilars a ‘better use’ of HSE resources

The clinical director of the National Centre for Pharmaeconomics (NCP), Professor Michael Barry, has called on the HSE to increase the uptake on biosimilar medicines.

It comes after Medicines for Ireland, the representative organisation for generic and biosimilar manufacturers, recently called for the immediate publication of a national biosimilar strategy, which was first promised by the Government in February 2017. MFI says that replacing expensive branded biologics with biosimilars could deliver potential savings of €25m. Professor Barry told RTE’s Morning Ireland recently that “we have seen a low uptake with generic medicines in the past, and we are seeing it again now with biosimilars. We are almost wedded to branded products.”

Professor Barry said while biosimilars are more complex than generic medicines, the HSE needs to stop ignoring the cost issue. “There is no doubt about that. It’s an issue that should be tackled. The HSE needs to take this one seriously and to have a good quality team producing a policy and also implementing it and, in addition, empowering excellent pharmacy units in our hospitals. There is also an appreciation among our own colleagues that safety and efficacy is very important but they cannot ignore the cost issue and I think prescribers for a long time have done just that.”

Professor Barry said increased prescribing of biosimilar medicines would constitute a better use of the HSE’s resources and urged the executive to start a process whereby biosimilars become the norm, as opposed to the exception.

“The first thing is to have a biologics policy to make it clear, for example, that unless there is a very good reason, someone starting on biologics should start on a biosimilar. Then you have got to put in the structures to enable this to happen at hospital level. We have spent the last five years concentrating on community expenditure because that is where most of it takes place, but we need to get to grips with hospital prescribing.”

Prof Barry gave examples of two particularly expensive medicines which cost the health service millions of euro each year: Adalimumab, sold under the trade name Humira and used to treat a variety of conditions including Crohn’s disease; and etanercept, an injectable drug used for treating rheumatoid arthritis.

“Between the two you are talking around €200m a year. That’s a lot of money. We need to be putting resources where they are needed, looking after our elderly, etc, so why waste them on medicines when you don’t need to?” said Prof Barry.

Describing the use of biosimilars as a no-brainer, Prof Barry said resources are needed to put the strategy in place.

“You need to get together a good-quality, experienced team to drive this initiative on and implement it but also to empower our hospital pharmacies to ensure it’s delivered,” he said.

Meanwhile Generic drugmaker Mylan has also called on the Government to boost its efforts in approving biosimilar drugs for use here in a move that could save the State around €140 million a year.

The US/Dutch company with a number of operations in Ireland said some Irish hospitals had already opted to purchase biosimilar medicines, but that the “legislature are lagging behind their own HSE”.

A biosimilar is a biologic medical product almost identical to the original and manufactured by a different company. The products are manufactured once the original comes off patent.

Mylan’s country manager Owen McKeon said Ireland was lagging significantly behind Europe in the take-up of biosimilars where an estimated €1.5 billion in savings have been achieved since 2006, equating to the employment of approximately 40,000 nurses.

“Biosimilar medicines have proved their value to patient care right across Europe for over a decade now. They are playing a key role in providing increased access to and more affordable medicines to patients and national health services. Yet in Ireland we have failed to embrace this change, and are now falling far behind our European colleagues.”

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