TY - JOUR
T1 - How do hospital characteristics and ties relate to the uptake of second-generation biosimilars?
T2 - a longitudinal analysis of Portuguese NHS hospitals, 2015–2021
AU - Perelman, Julian
AU - Duarte-Ramos, Filipa
AU - Melo Gouveia, António
AU - Pinheiro, Luis
AU - Ramos, Francisco
AU - Vogler, Sabine
AU - Mateus, Céu
N1 - Funding Information:
This study was financed by an unrestricted grant by the Portuguese Association of Generics and Biosimilars (APOGEN) to the Nova National School of Public Health. The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript. The funder was informed that the paper was submitted, and agreed with the submission. Authors not affiliated to the Nova National School of Public Health did not receive any funding for participating in this study.
Publisher Copyright:
© 2022 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2023
Y1 - 2023
N2 - Background: There is limited evidence on within-country discrepancies in biosimilar uptake. This study analyzes differences in timing and diffusion of biosimilar uptake across Portuguese NHS hospitals and explores possible determinants. Research design and methods: We analyzed publicly accessible consumption data of originator biologic and biosimilar drugs for adalimumab, etanercept, infliximab, rituximab, and trastuzumab, by hospital and month for the years 2015–2021 (N = 9,467). We modeled the time to biosimilar adoption using survival regression models and the share of biosimilar consumption using generalized estimated equations with random hospital effects. Results: Academic hospitals were characterized by a quicker uptake of adalimumab and infliximab biosimilars but lower shares for other drugs. A higher total consumption of biologics was related to a lower share of biosimilar uptake. A stronger participation in randomized controlled trials was linked to higher biosimilar shares and quicker uptake, except for rituximab. If all NHS hospitals had biosimilar shares equal to the highest ones, potential annual savings could reach 13.9 million euros. Conclusion: The findings suggest a need for capacity-building on biosimilar prescribing, including for doctors of academic hospitals and those working in settings where high biosimilar use would be expected.
AB - Background: There is limited evidence on within-country discrepancies in biosimilar uptake. This study analyzes differences in timing and diffusion of biosimilar uptake across Portuguese NHS hospitals and explores possible determinants. Research design and methods: We analyzed publicly accessible consumption data of originator biologic and biosimilar drugs for adalimumab, etanercept, infliximab, rituximab, and trastuzumab, by hospital and month for the years 2015–2021 (N = 9,467). We modeled the time to biosimilar adoption using survival regression models and the share of biosimilar consumption using generalized estimated equations with random hospital effects. Results: Academic hospitals were characterized by a quicker uptake of adalimumab and infliximab biosimilars but lower shares for other drugs. A higher total consumption of biologics was related to a lower share of biosimilar uptake. A stronger participation in randomized controlled trials was linked to higher biosimilar shares and quicker uptake, except for rituximab. If all NHS hospitals had biosimilar shares equal to the highest ones, potential annual savings could reach 13.9 million euros. Conclusion: The findings suggest a need for capacity-building on biosimilar prescribing, including for doctors of academic hospitals and those working in settings where high biosimilar use would be expected.
KW - Biosimilar
KW - diffusion
KW - hospital-related determinants
KW - intra-country differences
KW - Portugal
KW - savings
KW - uptake
UR - http://www.scopus.com/inward/record.url?scp=85142246539&partnerID=8YFLogxK
U2 - 10.1080/14737167.2023.2146579
DO - 10.1080/14737167.2023.2146579
M3 - Article
C2 - 36356294
AN - SCOPUS:85142246539
SN - 1473-7167
VL - 23
SP - 99
EP - 109
JO - Expert Review of Pharmacoeconomics and Outcomes Research
JF - Expert Review of Pharmacoeconomics and Outcomes Research
IS - 1
ER -