225. SWITCHING TO BIOSIMILAR ETANERCEPT IN CLINICAL PRACTICE

Abstract

Background: The first biosimilar etanercept product was granted a marketing authorization by the European Medicines Agency in January 2015. The introduction of biosimilars can deliver significant savings to the NHS while achieving similar clinical outcomes. Acute Trusts can negotiate a share of the savings with Local Clinical Commissioning Groups. We report our early experience of introducing the first selfadministered biosimilar anti-TNF. Methods: Specialist rheumatology pharmacists sought agreement from the consultant rheumatologists and specialist nurses to implement a phased switch from originator to biosimilar. Local commissioners agreed to share the savings with the Trust and a switching pathway was developed and agreed by all clinicians. Letters were sent to all patients explaining the proposed switch and inviting them to attend a face-to-face switching clinic with a specialist pharmacist and nurse. A specialist pharmacist telephoned all patients prior to the switch and coordinated all new homecare prescriptions and registrations with the specialist rheumatology nurse. The clinical trials nurse was informed of the switch in order to update biologic registry data. A letter was sent to each patient's GP informing them of the switch. Results: All 109 existing patients on originator 50mg etanercept were contacted regarding the switch [67 female (61.5%) 42 male (38.5%), mean age 49.3 years (S.D. 15.0)]. Diagnoses were 53 (48.6%) rheumatoid arthritis, 28 (25.7%) psoriatic arthritis, 25 (22.9%) axial spondyloarthropathies, 2 (1.8%) juvenile idiopathic arthritis and 1 (0.9%) Behcets. Over a five month period, 103 (94.5%) patients agreed to switch. Of the remaining patients, 2 were switching to an alternative biologic, 2 wished to discuss with their consultant at their next appointment and 2 could not be contacted over the phone. By the end October 2016, 80 (77.7%) patients had received supply of biosimilar etanercept and the mean number of doses supplied were 10.2 (range 1-24, median 8). The homecare delivery company offered training on the new device to all patients although the majority declined. Only 3 patients requested face-to-face consultations. No complaints or queries were received by the rheumatology nurse helpline regarding the switch. For the first 7 months of the financial year, the NHS had saved £112,410 as a result of the switch. Conclusion: Rheumatology patients were successfully switched to etanercept biosimilar, and almost all were happy to do so after receiving a letter and telephone consultation. To date, no complications or loss of efficacy has been observed. Our experience supports the routine switching from originator to biosimilar etanercept.