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.”
HHS Praises Biosimilars Savings but Opportunities to Reduce Part B Spending Remain
November 28th 2023Although biosimilars have already generated savings for Medicare Part B programs and beneficiaries, opportunities for substantial reductions in spending remain, according to a report from the HHS.
Dr Fran Gregory Sizes Up the US Adalimumab Market: Will Biosimilars See Success?
September 17th 2023On this episode of Not So Different, Fran Gregory, PharmD, MBA, vice president of emerging therapies at Cardinal Health, analyzes the adalimumab market so far in the United States and provides insight into how the market needs to adapt to accept these products and ensure lower drug costs for patients.
Adalimumab Biosimilars Take Center Stage: A Game Changer for IBD Treatment
July 16th 2023Laura Wingate, from the Crohn's & Colitis Foundation, explains some of the challenges regarding educating patients and providers on biosimilars for inflammatory bowel disease (IBD) as well as whether the gastroenterology space is ready for the influx of adalimumab biosimilars.
Real-World Data Confirm Safety, Efficacy of CT-P13 in Inflammatory Diseases
November 9th 2023A real-world analysis from Japan confirmed that CT-P13, an intravenous infliximab biosimilar, had comparable safety and efficacy to the reference product (Remicade; infliximab) in patients with immune-mediated inflammatory diseases.
Physicians Agree on Safety of Biosimilars, Nonmedical Switching in IBD, Survey Says
November 2nd 2023An international survey found that providers agree that use of biosimilars in inflammatory bowel disease (IBD) is safe and effective in both patients who are treatment-naïve and those who are already being treated with a reference agent.