Uptake of biosimilars for TNF-α inhibitors adalimumab and etanercept following the best-value biological medicine initiative in Ireland


Background There is over 10 years of clinical experience and evidence to show that biosimilar medicines can be used as safely and effectively in approved therapeutic indications as their originator biological medicines. In Ireland, biosimilar medicine uptake has been very slow, and savings to the health service will only be realised through fostering a competitive biological medicine market. Objective The objective of this study was to investigate the utilisation of biosimilars following a ‘best-value biological’ medicine initiative for adalimumab and etanercept in the Irish healthcare setting. Methods Data was extracted from the National High Tech claims database and High Tech ordering and management hub for the following drugs; adalimumab (Humira®, Amgevita®, Hulio®, Idacio®, and Imraldi®) and etanercept (Enbrel® and Benepali®). Main outcome measure: uptake of the best-value biological medicines. Results In June 2019, just over 90 patients had been initiated on, or switched to a best-value biological for adalimumab or etanercept. Over the next 12 months this increased to over 8500 patients. With the best-value biologicals accounting for approximately 50 % of market share in June 2020, the combined estimated savings and avoided costs are €22.7 million to date. The gain-share prescribing incentive has raised over €3.6 million for the specialties to invest back into patient care. Conclusion Against the background of a finite healthcare budget, this study shows that increasing use of biosimilars can create the financial savings and space to invest in new innovative therapies for the benefit of many patients.

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Availability of data and material

The data that support the findings of this study are available from the HSE-PCRS but restrictions apply to the availability of these data, which were used under licence for the current study, and so are not publicly available.

Code availability

Data analyses were carried out using custom code (SAS® 9.4) and Microsoft Excel.


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We would like to acknowledge the HSE-PCRS for facilitating access to the data.


No specific funding was received for this research.

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Correspondence to Amelia Smith.

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Duggan, B., Smith, A. & Barry, M. Uptake of biosimilars for TNF-α inhibitors adalimumab and etanercept following the best-value biological medicine initiative in Ireland. Int J Clin Pharm (2021). https://doi.org/10.1007/s11096-021-01243-0

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  • Biological medicines
  • Biosimilar medicines
  • Health technology management
  • TNF-α inhibitors