PMS6 - EFFECTIVENESS OF BIOSSIMILARS UNDER HOSPITAL PHARMACY MANAGEMENT POLICY

To assess the effectiveness of hospital pharmacy management in the biosimilars policy at Centro Hospitalar e Universitário de Coimbra (CHUC) Portugal. In October CHUC implemented Fully Integrated Biosimilars utilization management System (FIBS) managed by the hospital pharmacy. FIBS is based on prescription and dispensing by international non-proprietary name. Hospital Medicines and Therapeutic Committee (HMTC) recommends the option for the best economic value biologic drug if biosimilars are available. Non-biosimilar utilization has to be clinically justified on a patient by patient basis by prescribing physicians. The latter decision needs to be validated by the Hospital board, HMTC and Hospital Pharmacy which acts as system gate keeper. FIBS allow total traceability including biologic identification by tradename and batch number. Policy implementation was assessed by the extend of switching to or initiation of biosimilars by disease area. Biosimilars effectiveness was assessed by persistence on biosimilar treatment. This analysis includes all 602 patients using biologic therapy in rheumatic (36.2%), gastrointestinal (28.6%), hematologic (24.4%) and nervous system (11.6%) diseases and others (3.2%), since October 2017 when biosimilars for etanercept, infliximab and rituximab became available. Median follow-up time was 5 months. Switching to or initiation of biosimilars (SWT+INI) by disease area occurred in: rheumatic (83.0%+7.3%), gastrointestinal (64.0%+23.3%), hematologic (3.3%+63.4%) and nervous system (57.1%+14.3%) diseases and others (47.4%+26.3%). The proportion of patients in biosimilars was 81.9% and by biologic drug (SWT+INI): etanercept (82.6%+6.4%), infliximab (71.6%+17.9%) and rituximab (21.7%+46.7%). Median treatment duration with biosimilars was 3.2 months and the proportion persistence on their biologic therapy was 99.8% for biosimilars and 98.2% for branded drug. Hospital pharmacy management in the biosimilars policy at CHUC was associated with substantial and rapid biosimilars incorporation and utilization. Despite short term follow-up no difference was found in the effectiveness of biosimilars and branded drugs.