AB1202 SWITCHING OF ETANERCEPT IN A MONOGRAPHIC CONSULTATION OF BIOSIMILAR CLINICAL PRACTICE AND ECONOMIC COST

Abstract

Background: The recent appearance of biosimilars by the European Medicines Agency in January 2015 allows a quality treatment in rheumatic diseases with a lower cost. We present our initial experience in a specific biosimilar consultation with the introduction of biosimilar Etanercept (BE). Objectives: To describe the switching experience from original etanercept (OE) to BE and to evaluate the economic impact of this strategy. Methods: Retrospective study carried out in a tertary level hospital. We included patients treated with OE which were evaluated in the Specific Biosimilar Consultation where a rheumatology and a nurse proposed them switching to BE. Demographic, clinical and pharmacotherapeutic variables of all patients were collected. The outcome evaluated was the drug switch as well the reasons why the change was not made. To analyze the economic impact, the estimated savings in the use of BE vs OE was calculated, [costs according to the net prices of our center (PVL - discount)+VAT]. Results: The registry included of 133 patients treated with OE from the Rheumatology Department of our center, only 56 patients were evaluated in a period of 3 months in the specific biosimilar consultation: 73% were women over 53 years (17-75 years). Regarding the diagnosis: 45% rheumatoid arthritis, 46% psoriatic arthropathy and 9% ankylosing spondylitis. All patients chosen to switch from OE to BE should have stable base disease (defined as low activity according to the specific scale for each pathology), approval of the change by a evaluating physician and patient, signing the informed consent. Finally, the switch from OE to BE was performed in 31/56 patients (55%). In the 25 patients who did not change: 3 patients (12%) had moderate or high disease activity, in 8 patients (32%) the change was not accepted by the patient or by the evaluating physician and 14 patients (56%) were in remission of the disease. The patients chosen were in a dosage regimen of 50 mg/week, so the annual costs per patient are 9143.16€ with OE and 6095.44€ with BE. The switching to BE represent annual savings of 3047.72€ per patient and 94479.32€ total. Conclusion: The experience with the implementation of a specific biosimilar consultation in our center has been positive. In the first 3 months of its operation, the switching from OE to BE have been made in 55% of patients allowing savings allowing savings of 3047.72€ per patient/year. References [1] Brites L, Costa F, Freitas J, Luis M, Coutinho M, Santiago M, et al. Impact of Block Switch to Biosimilar Etanercept in Practice, Accross Different Rheumatic Disease [abstract]. Arthritis Rheumatol. 2018;70 (suppl 10). [2] Di Giuseppe D, Frisell T, Ernestam S, Forsblad-D’Elia H, Lindqvist E, Lindström U et al; ARTIS group. Uptake of rheumatology biosimilars in the absence of forced switching. Expert Opin Biol Ther. 2018 May;18(5):499-504. [3] Glintborg B, Loft AG, Omerovic E, Hendricks O, Linauskas A, Espesen J, et al. To switch or not to switch: results of a nationwide guideline of mandatory switching from originator to biosimilar etanercept. One-year treatment outcomes in 2061 patients with inflammatory arthritis from the DANBIO registry. Ann Rheum Dis. 2019 Feb;78(2):192-200. [4] Tweehuysen L, Huiskes VJB, van den Bemt BJF, Vriezekolk JE, Teerenstra S, van den Hoogen FHJ, et al. Open-Label, Non-Mandatory Transitioning From Originator Etanercept to Biosimilar SB4: Six-Month Results From a Controlled Cohort Study. Arthritis Rheumatol. 2018 Sep;70(9):1408-1418. Disclosure of Interests: None declared