Local policies on biosimilars: are they designed to optimize use of freed resources?

Category: Original Research
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Keywords: biosimilars, Italian national health service, local policies

Introduction/Study Objectives: Different policies have been implemented to enhance uptake of biosimilars. As for demand-side policies, the literature has focused on interchangeability and substitutability recommendations, issued by national or regional policymakers. The evidence on actions taken by healthcare organisations (HCOs) on prescribing behaviour is limited. Furthermore, none investigated whether policies move from a policy framework aimed at appropriately reallocating resources gained through patent expiration. This paper aims at filling these gaps, investigating policies on biosimilars implemented at the local level in the Italian National Health Service.
Methods: Data were retrieved through a structured, validated questionnaire, administered online to all 199 public HCOs.
Results: 76 organisations in 16 of 21 Italian regions completed the survey. The majority of all HCOs implemented information/educational initiatives on biosimilars. Prescription targets on biosimilars vs. originators and off-patent vs. in-patent molecules were introduced in 62% and 75% of HCOs, respectively. Prescribers reaching targets are mostly rewarded trough monetary incentives. 75% of HCOs declared to perform systematic impact evaluation of biosimilars, focusing on their economic impact. However, only 21% of HCOs detect patient under-treatment due to budget constraints and how availability of cheaper drugs could help. Furthermore, according to 25% of respondents their HCO is involved in studies on biosimilars, but few respondents provided evidence of these studies.
Discussion and conclusion: Our findings show a high level of proactivity by HCOs regarding actions on prescribing behaviour for off-patent bio-drugs. However, it seems that structured actions aimed at appropriately reallocating resources gained through patent expiration are still lacking.

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