As we have already mentioned in previous posts, several international consultants have conducted studies estimating the economic saving that biosimilars could generate for the Spanish national health service. For example, the consultancy company GFK indicated that using biosimilars of adalimumab (Humira®, Abbvie), bevacizumab (Avastin®, Roche) and trastuzumab (Herceptin®, Roche) would reduce the cost of these drugs by 26%, 24% and 25% respectively (GFK, Factors Supporting a Sustainable European Biosimilar Medicines Market, June 2014). In another study, the consultancy group IMS Health indicated that by the year 2020, biosimilars could potentially generate a saving of 1.5 billion euros for the Spanish national health service, and a saving of between 50 and 100 billion euros for Europe and the United States (IMS Health, March 2016).
However, in order for all this to happen, biosimilars need to be introduced into clinical practice and to do this, awareness must be raised about them. A survey carried out in 2015 by the consultancy company PwC (PricewaterhouseCoopers) showed that only 17% of the respondents chose the correct definition for biosimilar from the options given (PwC Health Research Institute, Top Issues Consumer Survey, 2015). Therefore, training about biosimilars plays a crucial role in increasing the confidence of healthcare professionals, primarily doctors, in these drugs. In order to do this, impartial bodies run by experts need to provide clear information about these agents. As an example, the competent healthcare authority in Finland gives conferences in all university hospitals, and has a newsletter explaining the concept of biosimilarity and the advantages of these treatment options both in terms of patient accessibility and savings. In Spain, the Spanish Association of Biosimilars (Asociación Española de Biosimilares, BioSim) has been established, which serves as a platform for industry professionals and the general public to learn more about biosimilar drugs. The Spanish Generic Medicines Association (Asociación Española de Medicamentos Genéricos, AESEG) has set up a biosimilars debate forum aimed at doctors, in which medical associations and, more importantly, the Spanish Public Administration will also participate.
In February 2015, the Biosimilars Group (Grupo de Biosimilares) of the Spanish Generic Medicines Association (AESEG) held a seminar with spokespersons from the main political groups of the Health Committees of the Spanish Congress of Deputies and Senate. The Group, whose arguments were supported by professors Fermín Sánchez de Medina and Álvaro Hidalgo, called for the politicians’ collaboration in drafting and developing specific legislation for these biopharmaceutical products, whose placing on the market requires an economic investment of approximately 150 million euros. In fact, thanks to actions such as this, on 2 August 2016, the Spanish Ministry of Health, Social Services and Equality (Ministerio de Sanidad, Servicios Sociales e Igualdad) published the Price Referencing Order (SSI/1305/2016) in the Spanish Official State Gazette (BOE, Boletín Oficial del Estado). This date marks the arrival of biosimilars in the system. Álvaro Hidalgo, senior professor of Foundations and Economic Analysis at the Universidad de Castilla-La Mancha, also explained that “biosimilars, besides providing patients with better access to biological treatments, will add value to the Spanish national health service due to price reductions, which will lead to a significant saving, allowing financial resources to be allocated to other health areas, including R&D for new biological products”.
More recently, in March 2016, a symposium on the arrival of biosimilars and its impact on healthcare systems was held in Madrid. Representatives from the main political groups were present. Concha Almarza, Director General of IMS Health, was among the attendees. She pointed out that biological drug patents that expire by 2019 involve “a market of 1.3 billion euros” in very important areas such as oncology, multiple sclerosis and monoclonal antibodies. The Deputy Director General of Madrid pharmacies (Farmacia de Madrid), Encarnación Cruz, also attended. She explained that if biosimilars had already been introduced, it would have generated a saving of 40 million euros in Madrid. She noted that “60% of Hospital Pharmacy expenses” is due to biological products, and that the third most expensive prescription drugs, even in primary care, are biosimilars. The Deputy Director of Galician pharmacies (Farmacia de Galicia), Carolina González-Criado, explained that of the 10 most expensive drugs in her region, eight are biosimilars and, of these, seven have expired patents. She also highlighted that hospital spending on biological drugs has gone from 37% in 2005 to 48% in 2014, increasing from 68 to 159 million euros in these years. For this reason, she is calling for strategies to promote the use of biosimilar drugs, in order to reduce economic expenditure.