Using Biosimilar Infliximab Could Expand Treatment Access in Brazil, Researchers Say

In Brazil, patients with psoriasis and ulcerative colitis (UC) who do not have an adequate response to (or are intolerant to) treatment with small-molecule drugs do not currently have access to treatment with infliximab under the public healthcare system.

In an analysis presented at ISPOR 2019, a team of researchers sought to demonstrate the cost to incorporate biologic treatment for patients with these inflammatory diseases by using biosimilar infliximab instead of its reference.¹

The investigators used the DATASUS database to identify the number of patients who had not responded to conventional therapy during 2017 and who would be candidates for treatment with biosimilar infliximab. They also considered the maximum price to be paid by the government for reference and biosimilar infliximab and the average total population growth ratio for 5 years.

They found that 7905 patients with psoriasis or UC would be eligible for biologic therapy, representing a total of 85,848 potential units of infliximab in the first year to 88,807 by year 5. The budget impact of these units would total BRL $216 million (US $53.46 million) for the reference infliximab and BRL $204.3 million (US $50.56 million) for the biosimilar in year 1, and BRL $223.5 million (US $55.31 million) for the reference and BRL $195.2 million (US $48.31 million) for the biosimilar at year 5.

These results correspond with a potential biosimilar savings of BRL $99.5 million (US $24.63 million) over 5 years.

Using the biosimilar rather than the reference infliximab in the treatment of psoriasis and UC in the public healthcare system, write the authors, could broaden access while containing costs.

In the Brazilian private healthcare system, where biologics are used for inflammatory diseases among patients who do not respond to conventional therapies, biologics are responsible for substantial costs, and the same research team also conducted an analysis of how much biosimilar infliximab could save the private healthcare system over 5 years.²

For this analysis, the investigators evaluated annual consumption of infliximab using IMS Health data that covered 2017 to 2018. They also considered the percentage of annual increase in the number of beneficiaries. Biosimilar infliximab was considered to have begun at 10% in year 1, reaching 30% in year 5.

The budgetary impact of using infliximab for inflammatory diseases was BRL $407.9 million (US $100.96 million) for reference infliximab and BRL $393.8 million (US $97.47 million) for the biosimilar in the first year, rising to BRL $624 million (US $154.44 million) for the reference and BRL $559.6 million (US $138.50 million) for the biosimilar at year 5.

Using the biosimilar, the authors conclude, could help to provide access to treatment while providing important savings.

References

1. Alexandre RF, Saldato De Santana C, Senna T. Budgetary impact of infliximab biosimilar in the treatment of psoriasis and ulcerative colitis in the perspective of Brazilian public healthcare system. Presented at: International Society for Pharmacoeconomics and Outcomes Research 24th Annual International Meeting; May 18-22, 2019; New Orleans, Louisiana. Abstract PBI17.

2. Alexandre RF, Saldato De Santana C, Senna T. Cost minimization analysis of biosimilar infliximab in Brazilian supplementary healthcare systems. Presented at: International Society for Pharmacoeconomics and Outcomes Research 24th Annual International Meeting; May 18-22, 2019; New Orleans, Louisiana. Abstract PBI16.