• Warwick Smith
  • Keith Ridge
  • Ailsa Bosworth
  • Jatinder Harchowal
  • Timothy De Gavre
Director General, British Biosimilars

"How is the industry and the NHS working to promote greater adoption of biosimilars?"

NHS England has done a great job in bringing together the full range of stakeholders - NICE, ourselves, the ABPI, patient groups and doctors and nurses, to understand why switching is a perfectly natural, normal and safe thing to do, that is underpinned by the regulatory science.

NHS England has issued guidance for commissioners which suggests that it should be normal for new patients to be treated with biosimilars - if they are less costly than the originator, which they normally are – and that clinicians should consider switching existing patients from the originator to a biosimilar when it is less costly.

Huge congratulations should go to NHS England for bringing together their national biosimilars programme board. It features people like Keith Ridge, England’s chief pharmacist, as chair, who has shown great enthusiasm to bring around the table all stakeholders so we can work together.

Frankly it’s the only time where I have seen such a broad range of stakeholders come together with such enthusiasm. I think it comes down to the fact that any reluctance to use biosimilars is due to lack of understanding; so bringing everyone together means we can share knowledge and develop understanding and information materials. That’s what we have been doing and will continue to do.

Chief Pharmaceutical Officer, NHS England

"How are savings from biosimilars being spent?"

Biosimilars have been available on the European market since 2006 and can offer considerable cost savings to the UK health service. Biosimilars are currently commissioned nationally through NHS England’s Specialised Commissioning or directly by CCGs. One approach would be that the commissioner, whether NHS England or CCGs keep all the savings. However, a more successful approach is likely to be a “gain-share” methodology commonly known as “investment to save schemes”. International experience indicates that when the medical unit or department responsible for the relevant disease area receives a proportion of the savings for reinvestment in patient care, then uptake is more rapid.

Chief Executive and Founder of NRAS

"What are the key things biosimilars will mean for patients?"

The National Rheumatoid Arthritis Society (NRAS) believe biosimilars to be an important introduction to available treatments for autoimmune conditions including RA. Their benefit is that they are less expensive than the originator drugs they are replacing and this will allow savings to the NHS when switching patients. People doing well on a biologic are likely to do well on its biosimilar. People not doing well on an originator are less likely to do well on its biosimilar so care must be taken to select the right patients.

In order for patients to benefit from switching, the savings need to be equitably shared so that some savings can be reinvested by rheumatology departments in improving the service for patient benefit, such as recruiting an additional nurse.

Switching programmes can take time to organise and patients must be appropriately involved and informed. Patients should also be involved with other stakeholders when organising switching programmes.

Lastly, we must ensure that safety date is collected. You need many thousands of people to reveal rare side-effects, and we haven’t got data on those numbers yet.

NRAS has published a video interview on biosimilars with their Chief Medical Advisor, Prof. Peter Taylor, accessible here: www.nras.org.uk/biosimilars

Chief Pharmacist & Clinical Director, The Royal Marsden NHS Foundation Trust

“Which are the next disease areas to benefit from Biosimilars and will we see quicker adoption based on shared learning?”

The initial uptake of Biosimilars in therapeutic areas like gastroenterology and rheumatology has been variable and inconsistent. However, as the understanding of the development of Biosimilars increases coupled with the increased experience of using these agents in clinical practice, the opportunity to start using Biosimilars in oncology becomes significant. The pipeline of Biosimilars in development in oncology is large, with many pharmaceutical companies recognising the opportunity they bring to the NHS.

It is felt that the approach from programmes such as NHS England’s national Cancer Vanguard who have developed a centralised repository of information to support the introduction of the first Biosimilar in Oncology (Rituximab) will support a quicker uptake of Biosimilars across the country. The potential saving to the NHS of 100% adoption of Biosimilar Rituximab in Oncology is at least £60million for the NHS in England and likely to be significantly more. This is a significant opportunity to help manage the rising costs in the NHS and one that need to be actively supported.

UK Country Head, Sandoz

"What makes you so passionate about biosimilars?"

Five years ago, it was ‘bio-what?’ when you talked about biosimilars. But now the conversation is changing as  the NHS, clinicians and patients realise the importance of these drugs. The NHS, and other health systems around the world understand that the extent of savings they need to make to be sustainable they must embrace biosimilars as part of the solution.

We find ourselves now at a transformational stage, when we will see important life-changing molecules come off patent, and open up to biosimilar competition. I am excited to be part of an industry where use of these high quality biologics is set to accelerate.  Developed and developing economies will both benefit: for less wealthy economies, these drugs introduce biologic treatments that were previously unavailable; in wealthier societies, they will expand treatment options, allowing more patients to access biologic treatments, and at a much earlier stage of disease transforming quality of life and outcomes for more patients.

I’ve heard patients be reduced to tears when they think of their life without these treatments, so it’s really exciting and enormously rewarding to think I am doing something with the potential to remove some of the barriers to access and help people so much.