After Biosimilar Deals, UK Spending on Adalimumab Will Drop by 75%

This morning, the United Kingdom’s National Health Service (NHS) announced that it has completed negotiations over using the best-value adalimumab product, and it has arrived at a plan whereby it will save £300 million (approximately $386 million) of its current £400 million-per-year (approximately $514 million) spending on adalimumab.

These substantial savings, said the NHS, will allow the health system to pay for an additional 11,700 community nurses, or 19,800 more treatments for patients with breast cancer. The deal also puts the NHS on track to deliver on its efforts to save.

In announcing the deal that affects the more than 46,000 UK patients currently treated with the reference adalimumab (Humira), Simon Stevens, NHS England’s chief executive, said, “As part of the NHS’s Long Term Plan we are ensuring every penny of extra investment is wisely spent. Harnessing the power of competition between drug companies, NHS England has now freed up hundreds of millions of pounds of savings to reinvest in patient care. By working with patients and frontline clinicians we’ve now successfully negotiated the biggest ever set of savings on what was the NHS’ most costly drug.”

The NHS revealed that it had taken bids from biosimilar developers Amgen, Samsung Bioepis, Mylan, and Sandoz, as well as from AbbVie, maker of the reference adalimumab, Humira. While the NHS did not disclose how each of the developers fared in the tendering process, the NHS, in its October 2018 final briefing on the adalimumab tender process, said that it planned award lots to 4 biosimilar products, and the size of each lot would depend upon the strength of the offers made. The strategy meant that no supplier of adalimumab would be awarded the full market, but that each company would have an incentive to offer the most competitive price.

Now that the NHS has awarded its tenders, the work of implementing the transition to biosimilars begins. Prior to the advent of biosimilar adalimumab, the NHS released its commissioning framework for biologics, which seeks to ensure that at least 90% of new patients be prescribed the best-value adalimumab, and that 80% of existing patients be switched to the best-value adalimumab, within a year of a biosimilar’s launch. The NHS Specialist Pharmacy Service also released a suite of resources for clinicians to use with patients in discussions about switching from Humira to a biosimilar. These resources include a Frequently Asked Questions document, as well as a template of patient letter with information about what the switch might mean for them.

Switching patients to biosimilars has already led to significant cost savings for the NHS: infliximab biosimilars delivered £99.4 million in savings, etanercept biosimilars delivered £60.3 million, and rituximab biosimilars delivered £50.4 million, for a cumulative savings equivalent to approximately $275 million in US currency during the 2017 to 2018 fiscal year.