Efficiency - Best value biological medicines
Biological medicines are those that are made or derived from a biological source and as such, are complex, with inherent variability in their structure.
A biosimilar medicine is a biological medicine that is developed to be highly similar and clinically equivalent to an existing biological medicine.
Continuing development of biological medicines, including biosimilar medicines, creates increased choice for patients and clinicians, increased commercial competition and possible enhanced value propositions for individual medicines.
The aim of the indicator is to increase the appropriate use of best value biological medicines, including biosimilar medicines.
- A biosimilar medicine is “a biological medicine that is developed to be highly similar and clinically equivalent to an existing biological medicine”.
- A target has been set to increase the appropriate use of cost-efficient biological medicines, including biosimilar medicines, in line with guidance.
- Biological medicines including all biosimilars must be prescribed by brand name.
- Within the next five years a number of biological medicines will lose their patent protection thus increasing the potential opportunity of prescribing biosimilar medicines.
- The biological medicines with biosimilar versions available for use within NHS Wales that are currently being reported on within this NPI in 2020–2021 are:
- Infliximab – Inflectra®▼
- Etanercept – Benepali®▼, Erelzi®▼
- Rituximab – Truxima®▼
- Trastuzumab – Ontruzant®▼
- Adalimumab – Amgevita®▼, Hulio®▼, Hyrimoz®▼, Imraldi®▼
- Teriparatide – Movymia®▼, Terrosa®▼
Trend in biosimilar percentage
Biological medicines are often supplied to patients via the homecare route, and it should be noted that not all the data on homecare medicines are currently captured in the secondary care prescribing data system. Although this issue is being worked on, some medicines use reports may therefore currently be incomplete.
Switching between a reference product and its biosimilar (and indeed amongst biosimilar medicines) should be managed at the discretion of the individual prescriber in partnership with the patient, and with appropriate monitoring in place.
How can changes be made?
- Where AWMSG or NICE has recommended the reference medicine, the same guidance will normally apply to the biosimilar.
- At the time of dispensing there must not be automatic substitution of the reference product with a biosimilar medicine. Therefore, the clinician in consultation with the patient should make the decision on whether the reference or biosimilar biological medicine will be prescribed for the patient.
- All biological medicines, including biosimilars, must be prescribed by brand name.