More for less– the biosimilar filgrastim story
Biosimilars are a recent innovation in pharmaceuticals that have brought competition to the biologic medicines market. The first funded biosimilar in New Zealand was Zarzio, a biosimilar brand of filgrastim introduced in 2012. The price reduction and expanded patient access that resulted from this competition underscores the importance of biosimilars for future PHARMAC activity.
What are biologics and biosimilars?
Unlike most traditional medicines that are made through chemical processes, biologic products are made of, or from, living things like yeasts, bacteria or animal cells. They usually have a more complex structure than other medicines.
Competitor products of biologic medicines are known as `biosimilars’ – these are highly similar versions of an approved biologic medicine.
To be approved by regulators, biosimilar medicines must have demonstrated comparable quality, safety and efficacy to an approved biologic, such that there is no clinically meaningful difference.
Filgrastim and pegfilgrastim
Filgrastim, also known as GCSF (granulocyte colony stimulating factor), is a biologic medicine used to treat low white blood cell count in people undergoing chemotherapy treatment for cancer. Pegfilgrastim is a long acting version of filgrastim.
Historically, because of their relatively high cost, filgrastim and pegfilgrastim’s use had been limited – both in terms of the type of patients treated and the dosing or number of injections. This meant there were health benefits to be unlocked through funding an equally effective but lower cost alternative.
In 2011 PHARMAC became aware of biosimilar brands of filgrastim being approved internationally. PHARMAC ran a commercial process, seeking proposals from companies marketing original and biosimilar filgrastim brands. As a result we awarded a sole supply contract to Sandoz for its biosimilar brand of filgrastim, Zarzio – the first biosimilar drug funded in NZ – in late 2012.
Impact of the change
The effect of competition was immediately obvious. Zarzio was funded at a lower price compared to the original brand of filgrastim (Neupogen) and this gave PHARMAC the opportunity to allow wider funded access. Soon after, having lost some market share to biosimilar filgrastim, the supplier of pegfilgrastim (Neulastim), which remains on patent, reduced its price offering further savings. So Overall, the introduction of biosimilar filgrastim has significantly reduced the costs of the total GCSF market. In addition, there has been a nearly 25% expansion in usage which is still growing.
The cost reduction was significant and had wider effects, leading to increased usage which means more patients are receiving benefit from these important treatments.
Introducing biosimilar competition has sent a signal to suppliers about PHARMAC’s future intentions to harness the benefits of competition where possible for biologic medicines. The filgrastim story shows that this competition can spill over to similar products that remain on patent, creating even greater savings.
Biosimilars are likely to be increasingly important in New Zealand healthcare. In 2014, PHARMAC introduced another biosimilar – for the growth hormone somatropin – and many other biosimilars are in the pipeline. Of the competitive processes PHARMAC has run to date where there is biosimilar competition, half have been awarded to the originator brand and half to a biosimilar.
(originally published in 2014 Year in Review)
Last updated: 20 February 2020