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Uptake of rheumatology biosimilars in the absence of forced switching

Journal article
Authors D. Di Giuseppe
T. Frisell
S. Ernestam
H. Forsblad-D'Elia
E. Lindqvist
Ulf Lindström
C. Sjowall
J. Askling
Artis Grp Artis Grp
Published in Expert Opinion on Biological Therapy
Volume 18
Issue 5
Pages 499-504
ISSN 1471-2598
Publication year 2018
Published at Institute of Medicine, Department of Rheumatology and Inflammation Research
Pages 499-504
Language en
Keywords bDMARD, biosimilar, rheumatology, uptake, arthritis, biologicals, register, Biotechnology & Applied Microbiology, Research & Experimental Medicine
Subject categories Rheumatology and Autoimmunity


Background: To describe the uptake and system-level effects of the introduction of biosimilars in a setting without forced switching.Research design and methods: We used data from the Swedish Rheumatology Quality register from start of marketing of infliximab (Remsima (R) and Inflectra (R)) and etanercept (Benepali (R)) biosimilars until 31 December 2016. We compared users of each originator-product and its biosimilar(s) by line of treatment: bDMARD-naive patients, non-medical switchers (vs. matched patients remaining on originator), and patients switching from a previous bDMARD of another type.Results: From the start of marketing 1343 patients started an infliximab biosimilar (22 months) and 2691 started etanercept (9months). Overall, the introduction of these biosimilars resulted in an increase of the total number of ongoing infliximab and etanercept treatments (originator + biosimilar) . At the end of the study period, biosimilars accounted for 31% of all infliximab treatments and 31% of all etanercept-treated patients. For each line of therapy, we noted only small differences in patient characteristics between those starting the originator product vs. its biosimilar(s).Conclusions: Introduction of biosimilars have effects beyond replacement of the originator product, in terms of an increased rate of bDMARD initiation. Selection to non-medical switching displayed no particular disease- or patient-characteristics.

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