Many biosimilars have struggled to win significant market share in the US, where a range of legal and commercial barriers stop the widespread use of biological copies even after they are approved by the US Food and Drug Administration.
However, Health New England, a not-for-profit US health plan, has released data that suggest it is possible to accelerate biosimilar uptake. The data cover the use of Johnson & Johnson’s autoimmune blockbuster Remicade (infliximab) and its biosimilar competitors in the period after the health plan introduced a new initiative at the start of last year.
Health New England said, “Since implementation of this initiative, 93% of infliximab utilization has switched to the biosimilar product, resulting in estimated savings of approximately $1.7m (€1.5m).”
To drive biosimilar uptake, Health New England collaborated with Magellan Rx Management on the development of a prior authorization solution and a clinical policy to support the initiative.
The uptake achieved following the adoption of these methods is above the national average. US sales of Remicade fell almost 18% over the first nine months of 2019 but it remains a big selling product for J&J, generating revenues of $2.2bn in the country over that period. US sales of Pfizer’s Inflectra, the first biosimilar challenger to Remicade, over the same period totaled $208m.
J&J has been criticized for the tactics it has used to retain market share, with Pfizer going as far as to file a lawsuit accusing its fellow big pharma of anti-competitive practices. Last year, the US Federal Trade Commission began assessing whether J&J’s Remicade contracting practices violated antitrust laws.
Yet, even J&J’s critics accept that forces outside of its control limit biosimilar uptake. Notably, in the absence of interchangeability between biosimilars and originator biologics, people who already take a drug such as Remicade may continue to do so despite the availability of cheaper alternatives.
Pfizer cited those dynamics to explain why its biosimilar copies of oncology drugs have gained market share faster than its off-patent autoimmune products. New patients make up a higher proportion of the market for cancer drugs, creating more chances to get physicians to choose a biosimilar over an originator biologic.