According to Dr Paul Cornes, a Bristol oncologist, there is a lot of excitement among cancer specialists. The reason, he says, is the predicted explosion in the number of new cancer drugs, and the benefits these are likely to bring to patients.

“We know in theory what we need to treat cancer and now, the likelihood is that we are going to have the drugs we need to do it.”

Research tells us that cancer in adults is a complex disease. “This means that two, three or even four different drugs are needed to successfully treat some cancers,” says Dr Cornes - but at the cost of $10,000 per month per therapy, there are few healthcare systems around the world that can afford to offer more than one.


Same therapeutic effect


Biological drugs have made a significant contribution to cancer care, and particularly since 2013, when two high-use biosimilar cancer treatments were approved for UK use.  With biosimilar drugs offering the same therapeutic effect at the reference biologic, but priced at between 20-40% less, cancer specialists struggling with stretched prescribing budgets have their hopes pinned on 2020. This is when more biologic cancer drugs are due to come off patent, potentially, adding around 225 new cancer treatments to prescribers’ armamentaria.

For a cancer patient suffering even the most aggressive disease, these new treatments could translate into an extra 12-18 months of life. Dr Cornes says: “The hope is that biosimilars will allow the health service to afford new, innovative personalised cancer medicine that can be used to manage cancer like a chronic disease.

“Biosimilars could be a catalyst for equal access to cancer care, at a time when healthcare systems are financially strapped and costs are skyrocketing. This stands to make a massive difference to the lives of the people we treat.”


Safety and quality assurance


Prescribers in the UK are well-acquainted with the idea of prescribing the ‘me-too’ off-patent version of drugs; generic prescribing, where the patient receives paracetamol rather than Panadol, for example, accounts for around 85% of all prescriptions dispensed by UK pharmacies. Just as generic drugs are approved for safety, quality and efficacy before they are licensed for use, EU regulators have amassed considerable experience of biosimilars since the first was approved over 10 years ago. To date, regulators have identified no relevant differences between the safety of biosimilars and their reference biologic medicines.

Dr Cornes says: “Today clinicians are expected to prescribe items that as well as being right for the patient and their healthcare condition, are also affordable for the patient and the society in which they live. In my view we should expect biosimilars to make a big difference to the way cancer is treated.”