Doctors have been using biosimilars - copycat versions of complex ‘biologic’ drugs - for several years. These biologic drugs have revolutionised the treatment of bone and joint diseases, such as rheumatoid arthritis. But as these drugs are derived from complex proteins, they are hugely expensive to develop and manufacture. These costs come down significantly once other companies are able to make cheaper, chemically similar versions called biosimilars.

This offers doctors and patients the opportunity to discuss switching from a biologic drug to a biosimilar, according to Professor Ferdinand Breedveld, Head of the Department of Internal Medicine and Rheumatology at Leiden University Medical Centre in the Netherlands.


Drugs making a difference


Professor Breedveld, a rheumatologist who specialises in bone and joint diseases, says the potential for switching to biosimilars is making a “very important” difference in his field.

“Between one third and 40% of patients with chronic, rheumatic, inflammatory diseases will be treated with these agents [biologic drugs] during some period of their diseases” he says. “They rank among the top 10 drugs in terms of healthcare costs in this country and many others.

“That is a huge investment for healthcare systems. If they price can be reduced, even by a small percentage, the costs for the healthcare system would go down, and obviously that money could go into other sectors of society.”


Driving down the price of drugs


According to Professor Breedveld, switching from the original biologic drugs to cheaper biosimilars has resulted in a 40% saving in Scandinavia, as market forces and competition drive down the price of these treatments.

However Professor Breedveld says doctors in other fields have been slower to switch to using biosimilars, because it’s “human nature” for a patient, or a doctor, not to want to change a treatment that is working well.


Patients and doctors have a social responsibility


And he admits that switching a patient to a different drug for reasons of cost “is not an argument that is very appealing for a patient”. So he says, “it’s important that the discussion about switching takes place on a higher level [than just cost].”

“We now have so much experience [of using biosimilars] that we can be confident that they are really safe, and effective. But that doesn’t meant that switching should be an unavoidable consequence - the patient and the doctor should have a discussion. The doctor should be informed and the patient should be informed, and together I would hope they would share the social responsibility to choose the cheaper product - as optimal healthcare is shared decision making between patients and doctors.”