Last year, at the Festival of Biologics, a panel discussion took place on the ability to switch patients from an originator biologic product to its biosimilar. One of the points of discussions centered on the prospect of both switching the drug from originator to biosimilar and device at the same time.
Martin Perry, consultant physician and rheumatologist at NHS Greater Glasgow and Clyde, noted that patients are comfortable switching product: “Patients are used to having brand changes on many of their drugs, whether that’s paracetamol or whatever it might be, it’s not an unusual concept. Most patients are very supportive of looking to try the best value for money on the NHS – when explained in the right way, it’s usually not an issue.”
However, he noted that changing the form of delivery could be more of barrier: “When it comes to switching devices, such as to subcutaneous delivery, there is going to be a question about the device itself. Each time a switch is made, there is a requirement to make sure patients are confident using the particular device.”
The issue of device switching is becoming a more prominent one, as biosimilar developers are creating differentiated forms of delivery over originator products.
Last year, Celltrion gained marketing authorization for a subcutaneously-administered option of delivery of its infliximab biosimilar, named Remsima SC. The product became the first treatment option to offer this form of delivery for the treatment, including developing this method prior to the originator company, Johnson & Johnson.
Margaret Dolan, associate director market access EU biosimilars at Biogen, agreed with Perry that there could be an issue switching devices. She noted her own experience as a pharmacist and patients’ psychological barrier to any change in the form of medication.
She observed, “Even for patients using oral dose forms, such as tablets and capsules, patients do get confused when in January their pills are pink but in March they’re yellow.”
“With these devices, the patient needs to be confident. It’s not so much a drug switch (from originator to biosimilar) but a device switch, since the drug is the same,” she continued.
How much of an advantage the biosimilar developer that had introduced this differentiated form of delivery would gain at a country-level was discussed by Dorthe Bartels, who is an advisor to Amgros, which is responsible for the procurement and supply of pharmaceuticals in Denmark.
On the benefits offered by differentiated devices, Bartels stated, “Especially shelf life and practical issues [on devices] are crucial, [however] it still depends on the price and how much we want to pay [for the product].”
