The uptake of biosimilar infliximab by English Acute Trusts

OBJECTIVE: In February 2015, two infliximab biosimilars were launched in the United Kingdom, both subsequently recommended for use by the National Institute for Health and Care Excellence1. In November 2015, NHS-England released data on usage of infliximab by Acute Trust and by brand (both biosimilars and the reference product). In this study, we analyse and compare infliximab prescription rates between 157 Acute Trusts across 4 regional areas within England. METHOD: Acute Trusts were categorised according to usage of infliximab brands and geographical location. Data were analysed using descriptive statistics on Excel 2010. RESULTS: Out of 157 Acute Trusts, 70(45%) prescribed the reference and at least one of the biosimilar brands. 65(41%) prescribed the reference only, while prescription percentages were not reported for 22(14%) Trusts. Of the 70 biosimilar-prescribing Trusts 40(57%) did not have biosimilar prescription rates exceeding 20%, while for 14(20%) rates were between 20-40%, for 7(10%) rates were between 40-60%, and finally for 9(13%) the biosimilar infliximab prescription rate exceeded 60%. The London and South-of-England regions had the highest percentages of biosimilar-prescribing Trusts, with 59%(16/27) and 58%(22/38) respectively. North-of-England had the lowest with only 22%(11/49) of Trusts in this region prescribing biosimilar infliximab. CONCLUSIONS: Although biosimilar infliximab has been available for less than a year, it has been prescribed in 45% of Acute Trusts across England. By providing the latest prescribing trends of biosimilar infliximab, this study provides insight into the widely varying prescribing practices of biosimilars in Acute Trusts. Differences between regions may also reflect differences in offered prices per brands or differences in incidence rate of targeted diseases. Further studies targeting clinical guidelines and formularies may provide in-depth understanding of utilising biosimilars in medical practice. References: NICE (2015) Infliximab, adalimumab and golimumab for treating moderately to severely active ulcerative colitis after the failure of conventional therapy. NICE Technology appraisal guidance 329. Available at: https://www.nice.org.uk/guidance/ta32