Objectives Since April 2015, the availability of Infliximab biosimilars offered a new potential for cost savings in limited financial resources of the healthcare system. In Austria, there is currently no open tendering for drugs dispensed at charge of sickness funds and biosimilars take a long time to gain an appreciable market share overall. A contract made between the public hospital operator and the regionale sickness fund of the Eastern Austrian county Burgenland (BGKK) offered a new opportunity regarding the interface problems due to the dually financed (inpatient and outpatient care is separately financed in Austria) health system. Only outpatient care is covered by regional sickness funds.

Methods With reference to the NOR-SWITCH study (1), confirming the interchangeability of the branded Infiximab and infliximab biosimilar, and the large price advantage of the latter, the BGKK agreed as an exception in the Austrian health system on direct reimbursement of infliximab to the public hospital operator (inpatient care).

The cost savings were calculated based on the monthly invoices of the hospitals. Instead of € 477.19 for 100 mg of branded infliximab, the price for biosimilar infliximab does not exceed € 300.–. The 23 patients on biosimilar were infused with 9,400 mg infliximab overall.

Results After signing the agreement in December 2016, 23 consecutive patients, representing 82% of all patients on infliximab in Eastern Austrian county Burgenland, switched to or were incident users of an infliximab biosimilar, the 18% have not yet switched due to remaining stocks of branded infliximab or were adolescents where switching is not forced because of lacking data. According to the individual dosing and a price benefit of about 37%, monthly cost savings of about € 16,650.00 could be generated.

Conclusions Despite availability of cost-effective infliximab biosimilars in Austria, the drugs did not gain significant market share, in contrast to the Scandinavian healthcare systems, <4% vs. >90% in the first half year of 2016. Further research is needed including clinical data to strengthen the results of this pilot study.

References

1. Jørgensen, K. et al. Biosimilar infliximab is not inferior to originator infliximab: Results from the 52-week randomized NOR-SWITCH trial. United European Gastroenterology Week 2016; LB15.

References

Disclosure of Interest None declared