Submitted: 24 March 2016; Revised: 12 May 2016; Accepted: 19 May 2016; Published online first: 1 June 2016

As is the case with other European countries, biosimilars of somatropin, filgrastim, erythropoietin and infliximab have recently been marketed in Spain. According to IMS MIDAS MAT 09/2012 data, the uptake of biosimilars in the Spanish market has been traditionally lower to that reported in other European countries such as Austria, Germany, Greece or Romania (20% vs 50–70%). Ainhoa Aranguren Oyarzábal and colleagues from the Madrid Health Service, Spain investigated how efforts to improve the uptake of biosimilars in the country have been working.

To try and address this situation, the Assistance Direction of Pharmaceutical Management (ADPM) introduced a strategic approach in 2010. This initiative, along with other approaches, monitors the use of biosimilars with the aim of trying to improve the uptake of biosimilars in the region. Biosimilars use was monitored via the use of indicators, which were included in the Contract Plan – an agreement signed between the Madrid Health Service (MHS) and hospitals in the region. In 2014, the indicator %Biosimilar Drugs Cost Value, was included and in 2016 the percentage of patients on infliximab biosimilar (new patients) was added.

%Biosimilar Drugs Cost Value = Purchase cost of biosimilars of somatropin, erythropoietin or filgrastim/Purchase cost of all brands of somatropin, all brands or erythropoiesis stimulating agents or all brands of colony stimulating factors

The %Biosimilar Drugs Cost Value for the main hospitals in Madrid was 15.72% in 2014 and 20.07% in 2015. This indicator shows wide variation between different hospitals. Several hospitals had no patients using biosimilars in 2014 (0%) compared to other hospitals with use of biosimilars around 60–70%, see Table 1.

For the infliximab indicator, more than half of the patients that started an infliximab therapy in 2015 received a biosimilar (290 out of 536 or 54.10%). Considering all patients with an inflixi­mab prescription, 12.83% (343 out of 2,673) were treated with a biosimilar, see Table 2.

Table 2 shows the percentage of biosimilar patients on inflixi­mab, in the two scenarios (as a % of new patients and as a % of all patients) for the most relevant hospitals in the region.

In the experience of the authors, the Contract Plan has been an effective way to transfer the Regional Health System’s objectives to the hospitals. In addition, the indicators have been a useful tool to track usage, to compare different hospitals to each other, to evaluate trends over time and to obtain results.

A more detailed discussion of the methods used in the strategic approach, other approaches and the results and conclusions obtained by the ADPM is presented in several GaBI Online articles [1–5].

Competing interests: None.

Provenance and peer review: Article prepared based on the paper entitled ‘Best practice to improve biosimilars uptake: the experience of Madrid, Spain’ by Aranguren Oyarzábal A, López ­Centeno B, Alonso Castro V, Calvo Alcántara MJ, Cruz Martos E, Assistance Direction of Pharmaceutical Management, Madrid Health Service, Spain; internally peer reviewed.

Michelle Derbyshire, PhD, GaBI Online Editor

References
1. GaBI Online – Generics and Biosimilars Initiative. Improving uptake of biosimilars in Spain [www.gabionline.net]. Mol, Belgium: Pro Pharma Communications International; [cited 2016 May 12]. Available from: www.gabionline.net/Biosimilars/Research/Improving-uptake-of-biosimilars-in-Spain
2. GaBI Online – Generics and Biosimilars Initiative. A strategic approach to increase uptake of biosimilars in Spain [www.gabionline.net]. Mol, Belgium: Pro Pharma Communications International; [cited 2016 May 12]. Available from: www.gabionline.net/Biosimilars/Research/A-strategic-approach-to-increase-uptake-of-biosimilars-in-Spain
3. GaBI Online – Generics and Biosimilars Initiative. Approaches to increase uptake of biosimilars in Spain [www.gabionline.net]. Mol, Belgium: Pro Pharma Communications International; [cited 2016 May 12]. Available from: http://www.gabionline.net/Biosimilars/Research/Approaches-to-increase-uptake-of-biosimilars-in-Spain
4. GaBI Online – Generics and Biosimilars Initiative. Uptake of biosimilars increasing in Spain [www.gabionline.net]. Mol, Belgium: Pro Pharma Communications International; [cited 2016 May 12]. Available from: www.gabionline.net/Biosimilars/Research/Uptake-of-biosimilars-increasing-in-Spain
5. GaBI Online – Generics and Biosimilars Initiative. Improvement in uptake of biosimilars in Spain [www.gabionline.net]. Mol, Belgium: Pro Pharma Communications International; [cited 2016 May 12]. Available from: www.gabionline.net/Biosimilars/Research/Improvement-in-uptake-of-biosimilars-in-Spain

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