You know how you can save money by buying supermarket ‘own brand’ products rather than the pricier branded alternatives?
Well now the NHS is set to save up to £150 million per year by doing something similar with the single drug which costs it more money per year than any other.
‘Adalimumab’, usually sold under the trade name ‘Humira®’, is an anti-inflammatory medication used to treat a range of conditions including rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, Crohn's disease, ulcerative colitis and chronic psoriasis. More than 46,000 patients are currently prescribed the drug, costing the NHS in England more than £400 million per year.
That makes it the single most expensive item on the NHS’s medicines list and until now it has only been available as the original branded product, giving no option to ‘shop around’ – but that is about to change.
When a pharmaceutical company launches a new medicine it is protected by a patent, so that rival companies cannot analyse it then launch their own ‘copycat’ versions. It means the company can set a price for its new drug without fear of being undercut by rivals, allowing it to recoup the costs of developing the drug and make some profit from it, just as all businesses do.
For consumers, it means there is no choice but to buy the drug from the company which launched it and at the price it sets (though big organisations like the NHS can often negotiate more favourable deals). However, the patent runs out after 20 years, at which time other companies can legitimately launch their own versions of the drug, called ‘biosimilars’. This introduces competition into the market and inevitably brings down the cost of the drug as different producers vie to attract buyers.
The patent on Adalimumab expired this week and up to four ‘biosimilar’ versions of the drug could be available from the end of this year. While equally safe and effective, they will be considerably cheaper than the branded Humira® product, which is also likely to be reduced in price to compete with its new rivals. It all means that the NHS can begin to shop around for the cheapest version of a drug which it uses in very large amounts, with potential savings of up to £150 million per year being realised by 2021.
Since the new ‘biosimilar’ versions must meet the same quality controls as the original, patients switching to the new brands will probably not even notice, in much the same way that you might not notice a difference after switching from an original branded breakfast cereal to a supermarket’s cheaper ‘own brand’ version.
To take full advantage of the change, NHS England has issued guidance to its Trusts and Clinical Commissioning Groups (CCGs) across the country, telling them that nine out of 10 new patients should be started on the best value medicine within three months of a biosimilar launch. At least 80% of existing patients should also be switched to the best value option (which could be cut-price Humira® or a biosimilar) within 12 months.
NHS England’s chief executive, Simon Stevens, said: “Biosimilar versions of widely used, expensive drugs are already delivering safe, effective treatment for patients across the NHS, including those with cancer. Adalimumab is the NHS’s biggest spend on a single drug and we want more clinicians to switch to use the best value biologics, which will free up hundreds of millions of pounds to reinvest back into patient care.”
Last year the NHS spent £17.4 billion on medicines, an increase of one-third since 2010/11. NHS England recently announced plans to accelerate and widen the uptake of biosimilars in a bid to save up to £300 million a year by 2021. In 2017-18, the NHS saved over £200 million by using more biosimilar medicines.
NHS Improvement’s director of hospital pharmacy, Andrew Davies, said: “We’ve had some excellent uptake of existing biosimilars so far, which means more patients get access to high-quality, effective medicines and the NHS can re-invest savings into frontline care. The launch of biosimilar adalimumab will be the fifth major class of biosimilar launched for wider NHS use, and preparations have been put in place to make sure that more patients are able to receive this treatment as quickly as possible.”