That is a key question if long-run drug prices are going to come down for biologic products. We can decompose this question into 3 sub-questions: <\/p>\n
What share patients initiating therapy start on a biosimilar?What share of patients already using a biologic products switch to a biosimilar?Do patient of physician factors drive biosimilar prescribing patterns?<\/p>\n
A paper by Roberts et al. (2024)<\/a> aims to answer these questions using the medication infliximab as a case study. Infliximab is indicated for a variety of auto-immune diseases<\/a> (e.g., rheumatoid arthritis, Crohn\u2019s disease, psoriatic arthritis). <\/p>\n Methods<\/strong><\/p>\n The authors use data from the American College of Rheumatology\u2019s Rheumatology Informatics System for Effectiveness (RISE<\/a>) registry. RISE is drawn from electronic health records data from >1000 US rheumatologists. The authors run a multilevel logistic regression model clustering patients by practice to examine the share of biosimilar prescribing dependent on patient vs. physician practice factors. <\/p>\n Results<\/strong><\/p>\n Biosimilar initiation<\/strong>: The authors found that for patients initiating therapy, 21.6% received an infliximab biosimilar between 2017 and 2022. However, while <10% of patients initiated a biosimilar in 2017, by 2022 37% of Medicare patients, 51% of commercially insured and 55% of Medicaid patients initiated a biosimilar version of infliximab. Patients in the lowest socioeconomic status (as measured by Area Deprivation Index<\/a>) were more likely to initiate a biosimilar (RR = 1.29, 95%CI 1.01\u20131.66).Biosimilar switching<\/strong>. While there was an increasing trend to more biosimilar treatment initiation, switching from biologic to biosimilar was less common. \u201c86.4% of users who received at least two doses of infliximab stayed with the formulation they were initially prescribed.\u201d Most of the switchers switched from biologic to biosimilar (11.5%) with 1% switching from biosimilar to biologic and <1% switching between biosimilar versions of infliximab. Practice level impacts<\/strong>. The author\u2019s multi-level modelled revealed that 34% of the variation in switching was explained by variation between practices (as measured by the intraclass correlation coefficient<\/a> [ICC]). \u201cThe median new starts<\/em> on a biosimilar was 16% (IQR: 6%\u201327%) across practices. Nineteen practices had >40% of new starts on a biosimilar\u2026The median percent of patients switched <\/em>from bio-originator to biosimilar was 11% (IQR = 5\u201320%) but 14 practices switched >40% of their patients.\u201d<\/p>\n Predicted probability of starting on biosimilar infliximab among new users of infliximab, by insurance and year of infliximab initiation Overall, we see a trend towards increased biosimilar prescribing but still significant variability by patient socioeconomic status and insurance type with large variability in biosimilar use across rheumatology practices. <\/p>","protected":false},"excerpt":{"rendered":" That is a key question if long-run drug prices are going to come down for biologic products. We can decompose this question into 3 sub-questions: What share patients initiating therapy start on a biosimilar?What share of patients already using a biologic products switch to a biosimilar?Do patient of physician factors drive biosimilar prescribing patterns? A…<\/p>\n","protected":false},"author":0,"featured_media":2521,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[],"class_list":["post-2520","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-articles"],"_links":{"self":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts\/2520"}],"collection":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"replies":[{"embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=2520"}],"version-history":[{"count":0,"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts\/2520\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/media\/2521"}],"wp:attachment":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=2520"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=2520"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=2520"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
https:\/\/onlinelibrary.wiley.com\/doi\/abs\/10.1111\/1475-6773.14410<\/p>\n