2SPD-006 Economic impact of infliximab biosimilar referencing in the hospital

Background Since biosimilar infliximab’s arrival on the market in 2015, health authorities promote their prescription. The question arises of the medico-economic interest of the switch from an originator to its biosimilar in patients already treated. The NOR-Switch study gives us an answer in showing the non-inferiority of biosimilar CT-P13 against the originator in terms of effectiveness and tolerance. Since biosimilar (Inflectra) referencing in our hospital in 2015, all treatment initiations are done with the biosimilar and a switch is proposed to patients already treated with the originator (Remicade). Purpose To evaluate the economic impact of introducing the biosimilar infliximab in our hospital. Material and methods We made an evaluation between June 2015 (biosimilar arrival) and 2018 to measure the impact of this referencing. We used a prospective database since 2014 concerning all infliximab injections ((Remicade+Inflectra), patient, indication, number of vial per injection, cost). Results Patients are treated in rheumatology (83%) and gastrology (17%): rheumatoid arthritis, Ankylosing spondylitis, Crohn’s disease and haemorrhagic rectocolitis. Since 2014, vial consumption (annual and by injection) of infliximab has risen (+8% per year, from 1641 vials to 2117). The partition between biosimilar and originator has evolved since 2015: the biosimilar proportion has increased from 8% (160 vials) to 55% (1056). In addition to treatment initiation, we note a 30% switch in patients already treated by Remicade. Inflectra was introduced with a −36% price in comparison with Remicade. Since 2015, vial cost has decreased (−40% for both biosimilar and originator). Although the consumption grew, we observed an annual cost reduction of −15%. Since 2014, infliximab expenses diminish from €8 50 000 to €5 00 000 yearly. Due to the introduction of the infliximab biosimilar in our hospital, we estimate a cost savings of €1.1 million in 3 years. The maintenance rate is respectively 57% and 64% under Inflectra and Remicade. Conclusion Since 2015, infliximab consumption has increased but a lower price and health authorities’ promotion for biosimilars contribute to a cost reduction in both Remicade, Inflectra and, consequently, annual cost. This cost saving is helped by prescriptors’s willingness: systematic treatment of naive patients by biosimilar and switch proposal to patients already treated. Biosimilar referencing and prescription are part of the cost-saving approach: less money is therefore spent on more treated patients. References and/or acknowledgements No conflict of interest.