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Dang, HaoHung

University of British Columbia

The uptake of biosimilars has been slower than hoped in many jurisdictions across the globe. A concern has been raised that switch from originator to biosimilar would be associated with increased health care resource utilization (HCRU) such as increased physician visits and hospitalizations. However, the signals for these concerns have been based on small samples and potentially biased methods. In this study, administrative data were analyzed from British Columbia (BC), Canada where in the past 5 years, policies have led to patients with inflammatory bowel disease (IBD), inflammatory joint disease (IJD), and inflammatory skin disease (ISD) being switched from an originator to a biosimilar to maintain insurance coverage. A literature review was conducted using Embase, Medline, and Web of Science to update existing systematic reviews. HCRU and cost from current literature were summarized. An empirical analysis was undertaken using population-based, administrative databases (Population Data BC) from 2015 to 2021 including individuals with IBD, IJD and ISD based on ICD-9 and -10 codes. The cohort included those using originator TNF-α blockers (adalimumab, etanercept, or infliximab) before the mandatory switch policy. Descriptive analysis of HCRU components (physician visits, hospital days, emergency visits, and other medications) was conducted. An interrupted time series was used to assess the pre- and post-switch trend by treatment and cohort on total HCRU related costs. The literature review showed no pattern in increase HCRU and cost following a switch policy. The analysis on BC population included 6326, 6205, and 2474 patients in the IBD, IJD, and ISD cohorts, respectively. Based on descriptive statistics and interrupted time series analysis, no important changes in physician visits, hospital admission, or emergency visits following the policy occurred for all three cohorts. Overall, no important changes in HCRU costs due to the switch were observed, but a historical trend in decreasing hospitalizations in IBD cohort was identified. This study suggests concerns about biosimilar switch policies creating increases in other HCRU is unfounded in IBD, IJD, and ISD patients. Policy makers in other jurisdictions can feel reassured that mandatory biosimilar switching polices should not lead to increases in the cost of other healthcare resources.

Text

2024-06-28

Attribution-NonCommercial-NoDerivatives 4.0 International

http://hdl.handle.net/2429/88533

Population and Public Health

University of British Columbia

UBCV

http://creativecommons.org/licenses/by-nc-nd/4.0/