Budget Impact Analysis Of Biosimilar Infliximab For The Treatment Of Crohn's Disease In Six Central Eastern European Countries

Biosimilar infliximab (CT-P13) is the first licensed biosimilar in EU for Crohn’s disease (CD). It is expected that spread of biosimilars in the treatment of CD will lead to cost savings and it might improve access to biological therapies. The main aim of this study was to analyse the budget impact of introducing biosimilar infliximab for the treatment of CD in six Central Eastern European (CEE) countries’ – Bulgaria, Czech Republic, Hungary, Poland, Romania and Slovakia – health care systems. This budget impact model estimates potential impact of biosimilar infliximab on health care budget over three-year time frame from third-party payer perspective. Spreadsheet-based country specific population model was developed functioning in quarter year time units. The model tracked movement of CD population between main states: 1) immune therapy, 2) infliximab, 3) biosimilar infliximab, 4) adalimumab. Switching between biologics and biosimilar infliximab was taken into consideration as well. In scenario analyses different rates of interchanging and switching were analysed. A -25% price difference was assumed for biosimilar infliximab compared to originator. Budget impact was calculated as difference in total cost of scenarios with and without biosimilar infliximab. In 2013,4, 625 CD patients were treated with biologicals in the CEE. Over the 3-year period with gradually interchanging 80% of infliximab to biosimilar infliximab is expected to lead to a net benefit of 16,635,000 euros compared to the scenario in which biosimilar infliximab would not be available. In scenario in which interchangeabilty was disallowed the budget savings amounted to 7,842,000 euros. If budget savings were spent on reimbursement of additional biosimilar infliximab treatments, approximately further 889 or 420 patients could be treated in the six countries, respectively. Introduction of biosimilar infliximab treatment for CD in CEE is predicted to bring substantial cost savings or increase of the number of patients with access to biological therapy.