Biosimilars to treat rheumatoid arthritis

In Switzerland, rheumatoid arthritis (RA) is often treated using the biologic infliximab. There are now various biosimilars available but they are not yet widely used. The HTA report examines the efficacy, safety and economic impact of biosimilars if they are used from the beginning of treatment and if patients are switched from the originator biologic infliximab to a biosimilar. It also analyses ethical, legal, social and organisational aspects of starting treatment with biosimilars or switching to a biosimilar.

A literature review analysed data from 35 medical and health economics studies. The clinical trials show that biosimilars exhibit comparable efficacy, safety and side effect profiles as the originator biologic. A cost analysis revealed significant cost savings potential through reductions in the price of the infliximab originator biologic, the use of biosimilars directly from the start of treatment, and switching patients from an infliximab originator biologic to a cheaper biosimilar. If 60 patients with rheumatoid arthritis were treated with a biosimilar from the outset and some 1,000 were switched to biosimilars, savings of around CHF 10.9 million could be made within five years.

The report concludes that from a medical perspective, biosimilars can be used as equivalent to the originator biologic from the start of treatment or when switching treatment. There is no indication that the use of biosimilars results in ethical or social disadvantages for patients. In legal terms, the interchangeability of originator biologics and biosimilars is not yet regulated. The report also concludes that the hesitant use of biosimilars thus far may be due to organisational aspects, such as financial incentives for doctors if they prescribe the originator biologic.