A recent paper published in the World Journal of Gastroenterology examines the complexities posed by biologics and biosimilars in the transition care of adolescent patients who have inflammatory bowel disease (IBD).
A recent paper published in the World Journal of Gastroenterology examines the complexities posed by biologics and biosimilars in the transition care of adolescent patients who have inflammatory bowel disease (IBD). The authors, who practice gastroenterology at Southampton Children’s Hospital in the United Kingdom, define transition care as the planned movement of adolescent and young adult patients with chronic conditions from a child-centered to an adult-centered healthcare system.
Adolescents with IBD face unique age-related challenges: those taking oral medications and injections of biologics may experience delayed puberty and related issues of self-confidence. They may also have difficulty in communicating openly with new healthcare providers. Adolescent patients in the United States who attend college away from home may face additional challenges related to using their parents’ medical insurance, while patients in Canada, who must be treated as adults by age 18, must initiate transitional care at a younger age than they might in European nations. Pediatricians and adult practitioners may feel ill-equipped to effectively communicate treatment options to the adolescent patient population.
Biosimilars are of particular interest in transitioning this unique patient population to adult care; while monoclonal antibodies have revolutionized IBD treatment, biologics remain costly for health systems. Biosimilars have the potential to generate significant cost savings, and the paper’s authors cite a Royal College of Physicians audit that found that replacing infliximab with it’s biosimilar in all eligible patients with IBD in the United Kingdom’s National Health Service could realize an annual savings of £3 million (approximately $3.87 million). The authors also indicate that, in their Southampton health system alone, switching all patients with IBD from the reference to biosimilar infliximab could save the system up to £812,000 per year (approximately $1,046,586). Those savings could be directly invested into other services that would improve patient care.
However, switching from a reference treatment to a biosimilar is a particularly challenging decision in the transition care setting. While the British Society of Gastroenterology has advocated switching for patients with IBD, there are few data available on pediatric switching from reference biologics to biosimilars. Because anti-drug antibodies may develop within 2 to 3 treatments, the European Crohn’s Colitis Organisation recommends that patients with IBD not be switched for non-medical reasons, especially within the first 6 months of treatment with a biologic.
The authors of the paper suggest that switching in transition care—and potential problems arising from switching—can be avoided by initiating treatment for IBD only after a joint agreement between pediatric and adult teams. In the Southampton system, they report, joint meetings between adult practitioners and pediatric healthcare providers are used to make decisions on IBD treatment, and the practitioners send detailed treatment plans to both the hospital systems and to the affected patients for improved care coordination.
Adolescent patients should be made aware of all available options, however, and should have a proactive role in making decisions about their treatments. The authors suggest that adolescent patients with IBD should be encouraged to demonstrate responsibility in communicating with their healthcare providers concerning their therapies. “Although no data is available to prove this approach,” they say, “we feel this not only empowers patients to take active control but also helps in better compliance.”
Webinar Addresses Solutions to Improve Adalimumab Biosimilar Uptake
March 18th 2024Government policies, including those related to prescribing incentives and interchangeability, need to be reworked to encourage biosimilar adoption and create meaningful savings for health systems, according to speakers at a recent webinar.
Decoding the Patent Puzzle: Navigating the Legal Landscape of Biosimilars
March 17th 2024On this episode of Not So Different, Ha Kung Wong, JD, an intellectual patent attorney partner at Venable LLP, details the confusing landscape that is the US patent system and how it can be improved to help companies overcome barriers to biosimilar competition.
Biosimilars Gastroenterology Roundup for January 2024—Podcast Edition
February 4th 2024On this episode of Not So Different, we reminisce on all the major gastroenterology news from January, which brought several reports quantifying how the gastroenterology biosimilar market is progressing and marked the 1-year anniversary of adalimumab biosimilar competition in the US.
FDA Green Lights Second Tocilizumab Biosimilar
March 7th 2024The FDA has approved Fresenius Kabi's tocilizumab biosimilar (Tyenne; tocilizumab-aazg), making it the second tocilizumab biosimilar overall and first tocilizumab biosimilar to be approved with both intravenous and subcutaneous administration options.
Eye on Pharma: Canadian Aflibercept Settlement; Sandoz Acquires Cimerli; Payer Chooses Cyltezo
March 6th 2024Biocon Biologics settled with the maker of Eylea (aflibercept), announcing a launch date for its biosimilar competitor in Canada; Sandoz has officially acquired Cimerli, a ranibizumab biosimilar; AARP Medicare Rx from United Healthcare has added Cyltezo (adalimumab-adbm) and removed the originator (Humira) from its formulary.