Differences in UK healthcare professionals" knowledge,,attitude and practice towards infliximab and insulin glargine biosimilars

Objectives To investigate knowledge and attitudes of different healthcare professionals in UK towards infliximab and insulin glargine biosimilars. Methods UK medical consultants/registrars, nurses and pharmacists participated in anonymised, self‐administered web‐based survey distributed by professional associations. Key findings There were 234 respondents: medical consultants/registrars (150), nurses (58) and pharmacists (26). 76% of medical consultants/registrars, 84% of pharmacists and 53% of nurses understood what biosimilars were. Medical consultants/registrars and pharmacists had safety and efficacy concerns when switching patients compared to initiation. Nurses had similar levels of safety and efficacy concerns about initiation. Conclusion Healthcare professionals were more comfortable with the initiation of biosimilars than switching current patients. Medical consultants/registrars and pharmacists were more informed than nurses

Impact of the introduction of falls risk assessment toolkit on falls prevention and psychotropic medicines' utilisation in Walsall: an interrupted time series analysis.

OBJECTIVE: To determine the impact of the introduction of a falls risk assessment toolkit (FRAT) in a UK medical centre on the number and cost of non-elective admissions for falls and psychotropic medication utilisation. DESIGN: Interrupted time series analysis quantifying the number and cost of non-elective admissions for falls and primary care use data for Rushall Medical Centre before and after the implementation of FRAT at July 2017. SETTING: Data on the monthly number and cost of non-elective admissions for falls and number of referrals and assessment to the falls service were provided by Walsall Clinical Commissioning Group. Primary care prescribing cost and volume data for Rushall Medical Centre was derived from the Openprescribing.net website for prescriptions dispensed between April 2015 and November 2018. PRIMARY AND SECONDARY OUTCOME MEASURES: The number and cost of non-elective admissions for falls and number of referrals and assessment to the falls service, and the volume of utilisation of psychotropic medicines. RESULTS: Following the implementation of FRAT at Rushall Medical Centre in July 2017, the number of non-elective admissions for falls decreased at a rate of 0.414 admissions per month (p<0.033, 95% CI -0.796 to -0.032). The utilisation of psychotropic medications (alimemazine, citalopram, escitalopram, fluoxetine, mirtazapine, olanzapine and risperidone) decreased. The expenditure on psychotropic medications prescribed/used at Rushall Medical Centre decreased by at least £986 per month (p<0.001, 95% CI -2067 to -986). CONCLUSIONS: The implementation of FRAT at Rushall Medical Centre was associated with a reduction in the number of non-elective admissions for falls. Assessment of these patients together with deprescribing of psychotropic medications resulted in a reduction in the number of non-elective admissions for falls and associated costs

The effect of new biosimilars in rheumatology and gastroenterology specialities on UK healthcare budgets: Results of a budget impact analysis

Background: The approval of new biosimilars of infliximab, etanercept and adalimumab by the European Medicines Agency is expected to produce further cost savings to the healthcare system budget. Objectives: This study aimed to estimate the budget impact of the introduction of new biosimilars Flixabi®, Erelzi®, Solymbic®, Amgevita® and Imraldi® in rheumatology and gastroenterology specialities in the UK. Methods: A published budget impact model was adapted to estimate the expected cost savings following the entry of new biosimilars Flixabi®, Erelzi®, Solymbic®, Amgevita® and Imraldi® in the UK over three-year time horizon. This model was based on retrospective market shares of biologics used in rheumatology and gastroenterology which were derived from DEFINE Software and healthcare professional perspectives. Results: The model predicted that infliximab and etanercept biosimilars would replace their corresponding reference agents by 2020. Adalimumab biosimilars were predicted to achieve 19% of the rheumatology and gastroenterology market by 2020. Without the introduction of further biosimilars, the model predicted a reduction in expenditure of £44 million on biologics over the next three years. With the entry of Flixabi®, Erelzi®, Solymbic®, Amgevita® and Imraldi® the model estimates cumulative savings of £285 million by 2020. Conclusions: The introduction of new infliximab, etanercept and adalimumab biosimilars will be associated with considerable cost savings and have a substantial favourable impact on the UK NHS budget. The number of biosimilars and time of entry of is critical to create competition which will result in maximum cost savings

Biosimilars: market analysis and survey of factors influencing prescribing

Background: Biological medicines are effective but expensive options for treating patients with chronic and life-threatening diseases unresponsive to conventional small molecule medicines. The importance of biosimilars as an alternative to expensive originator biologics in treatment regimens is increasing year by year. This thesis aimed to examine the prescribing pattern of current marketed biosimilars and understand the potential factors influencing their prescribing in UK. Methods: Examples of generic medicines entry were analysed and compared and contrasted with the entry of biosimilars in both primary and secondary care settings. Web-surveys were conducted with 234 healthcare professionals (HCPs) and 182 service users to investigate their knowledge and attitudes towards biosimilars. Face-to-face semi-structured interviews were then conducted with 26 HCPs and service users to further elucidate interviewee’s perceptions of biosimilars. Results: Findings from the market analyses showed that the penetration of a generic and/or a biosimilar is governed by the cost, the number of products (competitors) and chronicity of use when the delivery devices are the same. When delivery device or another factor influencing prescribers’ perceptions of patient benefit differed, biosimilar uptake was inhibited. The findings from web surveys and interviews showed that both HCPs and service users had a good knowledge and understanding of biosimilars and their importance for cost savings. Concerns about safety and efficacy of biosimilars during the process of switching to biosimilars were expressed by HCPs and services users, although the extent of this concern varied with the clinical discipline. Conclusion: The introduction of biosimilars is associated with considerable cost savings to the NHS. There are subtle differences between specialists’ views on biosimilars and different uptake patterns. Factors influencing prescribing biosimilar medicines were similar but more complicated than generic medicines. Cost is a key driver for the uptake of biosimilars only when patients related factors were justified or equal