NHS rejects suggestion a lack of guidance has slowed biosimilar uptake

UK-based Napp - a privately-owned affiliate of Munipharma – criticised the National Health Service (NHS) last week, arguing that the organisation has been slower to adopt copycat versions of Remicade (infliximab) than health services in other EU countries.

The firm – which launched a version of infliximab in the UK in February​ – said “uptake [of the biosimilar] in the UK is less than 5% of the original brand”​ despite advice from NICE and Health Improvement Scotland setting out how it can be used in place of Remicade.

Napp compared this with the market share achieved by infliximab biosimilars in Denmark and Norway – around 90% and 69%, respectively - and suggested the slower uptake is due to a lack of NHS guidelines.

Andrew Roberts, director of Market Access at Napp, said: “There needs to be clear guidance and a robust system of accountability to drive faster adoption of biosimilar medicines at the CCG and Hospital Trust level​.”

But the suggestion a lack of guidance was hindering biosimilar uptake was rejected by Keith Ridge, Chief Pharmaceutical Officer, NHS England,

Ridge told us a recently published entitled ‘What is a biosimilar medicine?​’, “provides key clinical and non-clinical stakeholders with accessible information on how to support the appropriate use of all biological medicines, including biosimilar medicines for the benefit of NHS patients​.”

He added that: "As the range of biosimilar medicines increases, it is important that the NHS plans for their timely, appropriate and cost effective introduction. Therefore all staff in the NHS, from senior managers to commissioners, through to front line health professionals need to understand more about biosimilars​.”

Cost savings​

Napp also suggested that – because the biosimilar costs 40 – 50% less than Merck & Co’s originator – the NHS has missed out on considerable cost savings.

The claim about missed savings comes just weeks after a National Audit Office (NAO) report​ revealed the NHS spent £80m more on oncology meds than was allocated in Cancer Drugs Fund (CDF) – a much criticised​ scheme introduced by Tory Prime Minister David Cameron.

Napp said: “Changing all patients to one of the biosimilar versions [of infliximab] could save the NHS around £90 million – easily enough to offset the £80 million overspend reported for the Cancer Drugs Fund in 2014-15.”​

We asked Napp to estimate by how much it stood to benefit financially from greater NHS adoption of infliximab, but the firm did not respond.

Cancer drugs fund​

The CDF was set up to allow patients to access meds not commonly available on the NHS. However, a recent study​ suggests prioritizing cancer drugs lacks support. Other research​ indicates the approach is poor value for money in terms of quality of life years (QALYs).

Worse still is the suggestion by health economist Karl Claxton​ that Cameron’s Fund “has enabled manufacturers to sell their drugs to the NHS at prices beyond those it can normally afford.​

“The fund was originally proposed as a temporary measure until a price negotiation mechanism with manufacturers was in place. This has not happened. As a consequence, the problem that NHS patients face in accessing new cancer drugs continues to be their high prices.​”

Since this article was published Napp has told us that its "​motivation in issuing the press release is to highlight that the NHS is missing an opportunity to make significant savings that could be reinvested back into improving care for patients. ​

"The industry is often criticised for the high price of innovative new medicines, but our experience with our first biosimilar monoclonal antibody shows that the NHS will not move quickly to take up medicines even when there is a strong value argument."​