Biologics are medicines created in cells that are used primarily to treat autoimmune illnesses. You see a lot of ads for them these days for illnesses like rheumatoid arthritis, psoriasis, irritable bowel syndrome. They are very expensive, and there is a kind of generic version of a biologic called a biosimilar. There have been concerns about how effective biosimilars will be compared with the original biologic. This study says that at least for this biosimilar, moving everybody from the biologic to the biosimilar resulted in better symptom reduction that what patients got with the original biologic. Good news!
Switching from etanercept (Enbrel) to its biosimilar Benepali was successfully implemented in a single-center study of patients with rheumatoid arthritis, investigators reported here.
The switch program took place during 2017, and resulted in a cost saving of approximately £500,000 ($680,000) annually at current prices. Patients were sent a letter before the program began from the clinic's pharmacist, explaining the switch, and also received a telephone call to answer any questions they might have. Participants then attended an education session and were seen in a dedicated clinic staffed by a rheumatology consultant and specialist pharmacist.
Participants also completed an 11-part questionnaire that asked about tolerability and adverse events associated with the biosimilar. As to the ease of using the injector pen, there was an 11% increase after the switch to Benepali, from 7.8 to 8.6 on a scale, with 1 representing "very difficult" and 10 being "very easy."
"The Benepali pen was preferred to Enbrel, and patients commented on the easier technique and less manual dexterity required," the investigators noted.
Oral Steroid
When asked how patients felt their rheumatoid arthritis was responding, 75% said it was no different, 11% said it had improved, and 17% felt it was worse. And when asked "how pleased" they felt about the switch, 43% of patients said they were pleased and 23% were not pleased, while the remainder were indifferent or not sure.
A total of eight patients ultimately switched back to the originator etanercept. In five patients, this was because of adverse events including rash and diarrhea, and in three, it was because of difficulty with the autoinjector pen. In addition, there were two disease flares after the switch.
"The reassuring results of this switching program should positively encourage clinicians and patients to switch to the biosimilar in order to optimize the cost saving to the National Health Service," Shah and colleagues concluded.