Introduction: Introducing biosimilar infliximab for the treatment in rheumatology\n(rheumatoid arthritis and ankylosing spondylitis) and inflammatory bowel disease (Crohnââ?¬â?¢s\ndisease and ulcerative colitis) may reduce treatment costs associated with biologics.\nThis study aimed to investigate the budget impact of adopting biosimilar infliximab in\nfive European countries, considering that the budget impact includes the adoption of\nbiosimilar infliximab and the availability of biologic alternatives such as vedolizumab,\nbiosimilar etanercept, biosimilar rituximab, and other relevant factors.\nMethods: An existing budget impact model was adapted to forecast the budget\nimpact in the UK, Germany, France, Spain, and Italy. Epidemiological parameters\nwere derived from published literature reviewed in July 2015. Current market shares\nof biologics were derived from Therapy Watch (2012/2013 data). Respondents in a\nDelphi panel, conducted in 2015 and consisting of several leading rheumatologists\nand gastroenterologists from different nationalities, were asked to forecast uptake of\nbiosimilar infliximab and estimate the proportion of patients eligible for a particular type\nof biological treatment, including biosimilar infliximab. Scenario analyses assessed the\ninfluence of various factors, including price reductions, on the budget.\nResults: Uptake of biosimilar infliximab was particularly expected for naÃ?¯ve patients;\nswitching patients that already received other biologics was not expected much. Market\nshares after 5 years of biosimilar infliximab were âË?¼2% in rheumatology in all five countries\nand in gastroenterology ranged from 4% in France to over 30% in Italy. Except for France,\nbudgets were expected to decrease for rheumatologic diseases. For gastroenterology,\nbudgets were expected to decrease in Spain and Italy. Budgets were expected to\nincrease substantially in the UK and Germany, due to the introduction of vedolizumab\nin the studied period. In France, budget was expected to slightly increase for ankylosing\nspondylitis, Crohnââ?¬â?¢s Disease, and ulcerative collitis. Savings in budget were expected in all\ncountries, for all diseases, when larger price discounts on biosimilar infliximab were used.\nDiscussion and Conclusion: This study has shown that only when price reductions are\nlarge enough (i.e., 50% or more), physicians indicated that they will prescribe biosimilars.\nPolicy makers should ensure substantial price reductions and stimulate physicians to use\nbiosimilar products, to obtain savings in healthcare budgets.
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