In Europe, as in the US, Biosimilar Launch Prices Tell Only Part of the Story

In the United States, biosimilar launches have been met with disappointment over what many view as too-shallow discounts to reference products’ list prices.

However, as Aurelio Arias, a consultant at IQVIA, explained during the SMi 9th annual conference on Biosimilars and Biobetters, held September 26-27 in London, United Kingdom, the substantial savings that the European market has realized with biosimilars are not necessarily reflected in list prices, either. Arias noted that in Europe, discounts on list prices at the time of launch are not that much greater than they are in the United States, as most European biosimilars appear to launch at a 10% to 20% discount to the originator. These are “not necessarily the huge savings we were promised initially,” he said.

However, net pricing is likely to tell a different story. While Arias explained that net pricing is similar to “the dark arts” and can be difficult to assess, the available data in Europe show that health systems are achieving discounts of as much as 70% for some drugs, primarily for molecules that have 3 biosimilar products available.

He noted that the number of entrants above 3 did not make a substantial impact on price, however, and that in nations where only a single manufacturer can win a tender, average net costs are higher than they are in countries that have multiple-winner tenders.

The discounts that health systems have been able to achieve have proven to be deep enough to drive substantial uptake (Arias cited approximately 70% uptake for biosimilar trastuzumab in the Netherlands 2 months after the first product launched), even when adopting a biosimilar means forgoing newer devices or routes of administration.

According to Arias, in some health systems that had previously moved patients with HER2-positive cancer to subcutaneous administration of the reference trastuzumab (Herceptin), clinicians reverted to intravenous administration of the reference product as a way to prepare patients for the switch to the intravenous biosimilar.

Overcoming the challenge of moving patients to a biosimilar version of adalimumab may be even less of a challenge; while Humira maker AbbVie has created a reformulated version of the reference drug—administered with a slightly smaller needle that is designed to cause less pain at the injection site—Arias says that physicians and health systems are likely to trade a minor difference in patient discomfort for substantial cost savings. In fact, he noted, some health systems are reporting that they plan to run their stocks of Humira dry so that they can replenish their pharmacies with a biosimilar product on the first day of their tender agreements.