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German Study Calculates Adalimumab Biosimilar Savings From Earlier Intervention


Investigators evaluated both biosimilar vs originator savings and savings from earlier use of a lower-cost adalimumab biosimilar (Amgevita).

Investigators in Germany said that a comparison of adalimumab biosimilar (Amgevita) vs originator (Humira) treatment for patients with rheumatoid arthritis (RA) has demonstrated significant cost savings both for earlier treatment overall and for use of the lower-cost biosimilar vs the originator product.

Findings were presented at the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) 2021 virtual meeting, May 17-20, 2021.

RA is a chronic autoimmune condition associated with persistent joint inflammation, organ involvement, significant comorbidities, and “considerable adverse physical, economic, emotional, and social consequences,” authors of the study said. “The negative impact of RA can be cumulative over the course of a patient’s life.”

Investigators sought to weigh the economic effect of delaying the start of biologic treatment for RA and the potential savings from earlier treatment with adalimumab, which would be more feasible with the biosimilar than originator product because in Germany at current prices Amgevita is cheaper than Humira, investigators said.

They said that a 6-month delay in initiation of treatment with biologics was associated with cumulative incremental costs of $8177 per patient, which included loss of productivity. After 3 years, the cumulative costs of delayed treatment were more than $12,146 per patient; after 8 years, the cumulative costs were more than $24,291.

In addition, use of the biosimilar vs the originator product resulted in an overall lifetime reduction in costs (including drug costs, medical resource use, indirect costs, and monetized health outcomes) of $30,519 per patient, and this calculation is based on a 6-month delayed initiation of treatment for the more-costly originator product. This figure also represents a lifetime reduction in drug cost of $26,823 (Amgevita, $199,478; Humira, $226,303). Note that figures were converted from Euro values and rounded.

“Excluding the monetary value of health outcomes, cost neutrality compared with later treatment with adalimumab at current originator pricing was estimate to be achieved treating 3 years earlier, assuming patients are eligible to receive biologic treatment at that time,” authors concluded.

Investigators said significant savings on hospitalization and productivity loss were possible by initiating treatment earlier in the disease cycle.

“The model demonstrated the value of biologic treatment for eligible patients with RA and that avoiding delays in the initiation of biologic treatment could be cost saving,” they said. “Treating patients earlier may result in better health outcomes in the long term.”

Further, they concluded, “The costs of treating eligible patients earlier with Amgevita at current pricing levels are expected to be offset by later cost savings.”

In the European Union, competing biosimilar forms of adalimumab have been approved for use since 2017. In 2018, non-US sales of Humira peaked at $6.25 billion and began a swift decline. They measured $4.3 billion in 2019 and $3.7 billion in 2020. For a list of approved adalimumab biosimilars in the European Union, click here.


Porter J, Stuart P, Bartsch R, Lebioda A. cost-effectiveness analysis of adalimumab biosimilar compared to delayed biologic treatment initiation in patients with rheumatoid arthritis in Germany. Presented at: Virtual ISPOR 2021; May 17-20, 2021. Accessed May 16, 2021. https://www.ispor.org/conferences-education/conferences/upcoming-conferences/ispor-2021

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