£300 Million Savings on High-Spend Hospital Drug

Peter Russell

November 26, 2018

The NHS is set to save a record £300 million after negotiating deals with five manufacturers on less expensive versions of the drug that costs hospitals the most money.

The saving has been made possible by the introduction of biosimilar versions of adalimumab (Humira, AbbVie), which is used for severe hospital-treated conditions such as rheumatoid arthritis, inflammatory bowel disease, and psoriasis.

The exclusive patent for adalimumab expired last month, and NHS England said it had accepted bids from Amgen, Biogen, Mylan/Fujifilm Kyowa Kirin, and Sandoz to supply biosimilar versions. The ongoing use of Humira, manufactured by AbbVie, could also continue where clinically appropriate or where it was the best value, it said.

Currently, more than 46,000 patients are prescribed adalimumab in England and Wales at an annual cost of around £400 million a year. The deal should lead to hospitals saving three-quarters of that cost, twice the savings it predicted in October this year.

'Harnessing the Power of Competition'

Simon Stevens, NHS England’s chief executive, said: "As part of the NHS's Long Term Plan we are ensuring every penny of extra investment is wisely spent.

"Harnessing the power of competition between drug companies, NHS England has now freed up hundreds of millions of pounds of savings to reinvest in patient care.  By working with patients and frontline clinicians we’ve now successfully negotiated the biggest ever set of savings on what was the NHS's most costly drug.

"This is another example of how the smarter approach to biosimilar medicines in the UK and Europe gives patients and taxpayers a much better deal than they get in the United States."

Mr Stevens indicated that the money saved was the equivalent of hiring 11,700 community nurses or paying for 19,800 more breast cancer treatments, but the announcement did not give specific details of how the savings would be distributed.

Driving Down Costs

NHS England said, in partnership with NHS Improvement, it was on course to deliver on its ambition to cut £300 million from the nation's annual medicines bill a year earlier than its original target of 2021 through greater use of biosimilars.

NHS England has issued guidance to Trusts and Clinical Commissioning Groups (CCGs) telling them that nine out of 10 new patients should be started on the best value biological medicine within 3 months of a biosimilar launch.

It expects that at least 80% of existing patients should be switched to the best value biological medicine – either the originator or a biosimilar – within 12 months.

In 2016/17 the NHS spent £18.2 billion on medicines, an increase of more than one third since 2010/11. In 2017/18, the NHS saved over £200 million by using best value biologics.

Biosimilar versions of adalimumab are expected to be available to NHS patients from December 2018.

Last month, the National Rheumatoid Arthritis Society (NRAS), Crohn's & Colitis UK, the Psoriasis Association, and the National Ankylosing Spondylitis Society (NASS), issued a joint statement in which they welcomed the introduction of biosimilars for adalimumab.

However, it said it was vital that patients were fully informed about all the treatment options available to them, and that "commissioners and health professionals adopt the principles of shared decision-making".

NHS England promised to work closely with patient groups and clinical service providers during the transition period "to ensure that the very high quality of patient care is maintained".

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