PBI10 Economic Impact of Originator-to-Biosimilar Non-Medical Switching on Health Care Resource Utilization in Rheumatic Patients in Quebec, Canada


      A number of Canadian jurisdictions have or are planning to implement mandatory originator-to-biosimilar non-medical switching (NMS) by funding only less expensive biosimilars; however, other costs unrelated to drug acquisition may need to be also considered, including those pertaining to health care resource utilization (HCRU). The objective of this study was to estimate the economic impact of NMS on HCRU in Quebec, Canada.


      HCRU data over a 6-month period associated with patients with rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis who were stable on a biologic treatment who underwent a NMS or not were obtained from a systematic literature review (Tarallo, 2019 and Glintborg, 2018). Costs included were those associated with physician visits, hospitalization, emergency department visits, nurse visits, imaging, laboratory tests, productivity loss and transportation. These costs were obtained from Quebec sources, including governmental publications.


      Rheumatic patients who underwent a NMS incurred greater HCRU-related costs compared to those who stayed on the originator biologic ($3,085 per patient for switchers vs. $1,768 for non-switchers), for a difference of $1,317 per patient. The main drivers of the difference in costs between switchers vs. non-switchers were associated with hospitalization and productivity loss, with an increase of $563 and $360, respectively.


      The economic impact of NMS may be associated with an increase in HRCU-related costs to which hospitalisation is the biggest contributor. This should be considered by payers when evaluating biosimilar policy options. Moreover, given the ongoing uncertainty surrounding COVID-19, new policies that may increase HRCU could result in increased stress on the healthcare system.