• NHSI data suggests £170m saved in 10 months from switching to “biosimilars”
  • Savings could reach £200m by end of March
  • Uptake of cheaper medicine tops 90 per cent of trusts in one case

The NHS is estimated to have saved £170m in the first 10 months of this financial year by switching to cheaper versions of just three drugs.

Figures obtained by HSJ show that the savings came from the uptake of three “biosimilars”, instead of the original “biologic” medicine.

Biologics are complex medicines which are expensive to manufacture and are correspondingly costly for the NHS. A number have recently come off patent, resulting in cheaper biosimilars becoming available.

The figures, which are tracked through NHS Improvement’s model hospital top 10 medicines programme, show uptake has exceeded 90 per cent in one case. Savings from using biosimilar infliximab, which is used to treat rheumatoid arthritis and inflammatory bowel disease, were nearly £77m in the 90 per cent of trusts tracked in the first 10 months of the year, with uptake of 92.9 per cent.

Etanercept (also used for rheumatology conditions) was used in 87.7 per cent of cases with a saving of nearly £42m. Although takeup of the more recently launched biosimilar ritiximab (used for some cancers as well as rheumatoid arthritis) was lower at 63 per cent, it still saved £33m.

The model hospital does not capture data from all trusts. But if those savings had been replicated across all hospitals they would amount to £170m for the first 10 months of the financial year potentially £200m for the whole of 2017-18.

All of these drugs are normally prescribed in hospitals, rather than by GPs. However, clinical commissioning groups or specialised commissioners are most likely to benefit from savings because they pay for those medicines via “pass through funding”. There may be some cases where trusts and CCGs may have worked together on gainshare arrangements too incentivise trusts to use biosimilars.

CCGs are looking for increased savings from switching to biosimilars following the publication of a commissioning framework for them last autumn.

The document pointed out there is still significant variations in uptake between different hospitals of the available biosimilars but there were potential savings of up to £300m a year.

Later this year, the main UK patent on anti-inflammatory drug Humira (adalimumab) is expected to expire: this is the highest spend drug in NHS hospitals at more than £250m a year, which could be significantly reduced if biosimilars are prescribed instead.

Andrew Davies, professional lead for hospital pharmacy at NHS Improvement, said: “NHS trusts have worked incredibly hard to realise the potential savings of switching to high quality, good value biosimilar medicines rather than prescribing the originator biological medicine.

“From these three regularly prescribed medicines alone, patients have continued to receive high quality treatments, while trusts have saved the NHS over £170m in the last year which can be reinvested into treating more patients.”

Kavya Gopal, chair of the British Biosimilars Association and head of specialty at Sandoz UK, said: “The NHS has moved quickly to achieve the savings from biosimilar medicines and has become an example for healthcare systems across the world in the adoption of these medicines.

“What is crucial now is that the NHS continues to treat these medicines as a long term opportunity for patients and ensure that competition is maintained in the market, and pricing is not pushed to unsustainable levels.”