One Academic Medical Center’s Clinical Experience and Savings With Biosimilar Infliximab

A study was recently published in the Journal of Managed Care and Specialty Pharmacy that evaluated the clinical results and economic benefits of a switch to biosimilar infliximab (specifically Inflectra) compared with the reference product Remicade® in adult patients with inflammatory bowel disease (IBD).

The savings accrued from the widespread use of biosimilars has been valued at tens of billions of dollars over several years. Estimates of savings generally are made from the perspective of system-wide savings.

Conducted at Boston Medical Center, the study authors calculated cost savings attained with transitions to biosimilar infliximab from March 2018 to June 2019. The outcomes of these patients were also evaluated, using a variety of clinical indicators.

To optimize patient conversion to the biosimilar, medical center physicians worked with the pharmacy department to devise the following criteria: Switches were performed in patients who were already taking Remicade for at least 6 months, the physician approved the switch, the biosimilar was approved for coverage by the patient’s insurer, and the infliximab infusions were performed in the medical center’s outpatient infusion facility.

During this period, 146 patients (97%) of the total IBD patient population who were taking Remicade were successfully converted to biosimilar use. Evaluating a subgroup of patients who had certain clinical or disease rating scores available before the switch took place (40 patients), the researchers reported that 90% maintained their remission. Interestingly, C-reactive protein levels fell after patients moved to the biosimilar (but this difference, 11.2 ± 22.0 mg/L vs. 4.1 ± 4.8 mg/L fell short of statistical significance [P = .09]). By the end of the study period, 89% of patients taking the biosimilar continued with this therapy.

Based on these figures, the medical center estimates that it saved $500,000 per year when transitioning this patient cohort to biosimilar infliximab. The study authors stated, “These findings reinforce that certain barriers to biosimilar uptake can be successfully addressed to implement a robust biosimilar adoption program.” They concluded that not only is the transition feasible, but “no significant clinical differences were noted in adult patients with IBD who transitioned from [Remicade to Inflectra].”

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