At last week’s Festival of Biologics program in Basel, biosimilar attendees were treated to a preponderance of sessions involving streamlined biosimilar development—specifically, the removal of the phase 3 trial mandate by major regulators.

Although BR&R is keenly focused on the US biosimilar market, this year, we wanted to get a global perspective, by attending the Festival of Biologics European conference. Perhaps unsurprisingly, our colleagues on the continent are focused on the same hot topics that drive us in the US: development costs, competition, access, and government regulation.

At last week’s program in Basel, sessions featured the implications of streamlined requirements for biosimilar development—specifically, the removal of the phase 3 trial mandate by major regulators. Speakers addressed the cost savings resulting from this sea change in registration requirements, how it can spur activity within the biosimilar void, and what it means for biosimilar competition overall.

Biosimilars’ Value and Cost Savings to Shine With Lower Development Costs  

Amidst the pressures on market access and pharmaceutal pricing, “Biosimilars are one of the clearest examples of how to create value for the whole healthcare system,” said Isabel Remus, Global Head of Biosimilars, Sandoz.

“The opportunity ahead is unlike anything we’ve seen before,” she stated, based on value of biologics that will lose exclusivity in the next decade.

With the cost of healthcare innovation continuing to rise, health systems in each country need to be funded in a sustainable way. “Biosimilar competition is a key lever for value,” said Ms. Remus. Across different healthcare systems, there is strong evidence on how biosimilars create value. For example, in the EU, biosimilar competition generated 75 billion euros in cumulative savings, over 9.2 billion patient-days of utilization. In comparison, the US health system saw $56 billion in savings. These savings can contribute to both broader access to valuable biologic medicines as well as funding innovation for new disease treatments.

However, not all patients benefit equally from biosimilar access. Adoption remains uneven between countries and regions, she pointed out. Some reference products attract a lot of biosimilar competition, whereas some generate very little or none. “Removing key barriers can materially reshape what is achievable in biosimilar development,” Ms. Remus said. “We’re trying to get the time of biosimilar development down to 4-6 years at a cost per program down to $60 million to $150 million. Regulatory evolution can open future opportunities and open opportunities previously thought to be closed.”

This may be one of the most important periods in the history of biosimilars, she concluded. The environment is becoming more complex. “Success will require not only flawless execution but the ability to anticipate policy changes.”

Fifty Percent Savings in Total Cost of Biosimilar Development Is Possible When Avoiding the Phase 3 Trial

According to Mourad Rezk, MD, MSc, MBA, CEO, RezMed Consulting, the impact of waiving comparative efficacy studies (CESs) could be game changing for developers. He believes that the lower cost to bring a biosimilar to market may make it possible to consider reference product targets with far lower revenues than in the past, perhaps as low as $350 million per year.

Consider that CESs went from being a default requirement to only being required in exceptional situations within 5 years, starting with the UK’s Medicines and Healthcare Products Regulatory Agency (MHRA) in 2021. Since that time, the major pharmaceutical regulatory agencies “have come to the same conclusion but are not yet fully aligned on wording of their guidances. We need more harmonization,” said Dr. Rezk.

He outlined the few instances when a CES may still be required for regulatory approval:

• If the molecule is heterogeneous or poorly characterizable
• If the mechanism of action is not completely understood or it may have multiple mechanisms of action
• If the molecule is locally acting, and pharmacokinetic studies are not informative
• If the compound carries a high risk of immunogenicity or carries severe consequences if immunogenicity occurs
• If the biosimilar is the first applicant for a complex reference molecule

Some companies have chosen to continue their phase 3 studies, particularly with pembrolizumab biosimilar candidates. But with 50% savings potentially obtained through the avoidance of these CESs, some new players may decide to join the fray, Dr. Rezk believes. When you start to consider lower-revenue reference drug targets, it may be possible to “avoid the [biosimilar] void.” It may also be a boon for biosimilars in the rare disease space, he hoped.

This article was written by our Director of Content, Stanton Mehr. Stan has been writing commentary and reporting news about the biosimilar industry since the submission of the first biosimilar 351(k) application to the FDA 13 years ago. Since that time, BR&R has been tracking the US biosimilar marketplace, with the industry’s original, comprehensive and updated database of biosimilar filings with the FDA.