1
|
Husereau D, Feagan B, Selya-Hammer C. Policy Options for Infliximab Biosimilars in Inflammatory Bowel Disease Given Emerging Evidence for Switching. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2018; 16:279-288. [PMID: 29411318 PMCID: PMC5940725 DOI: 10.1007/s40258-018-0371-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Biosimilars are becoming increasingly available internationally as patents expire on the originator biologic drugs they are intended to copy. Although substitution policies seen with generic drugs are being considered as a means to reduce expenditures on biologics, some biosimilars pose particular challenges in that the act of substitution may eventually lead to increased rates of therapeutic failure. As evidence requirements from regulators do not directly address this challenge, switch trials of biosimilars have emerged that may provide further answers. Using infliximab in inflammatory bowel disease as an example, we critically examine emerging evidence from two key switch trials (NOR-SWITCH and NCT020968610) and discuss the clinical and economic implications of these and what policy options may be most reasonable for payers. Options include reimbursing biosimilars for only newly diagnosed patients, using product-listing agreements to manage uncertainty, or using tiered co-payments or other incentives to promote biosimilar use.
Collapse
Affiliation(s)
- Don Husereau
- School of Epidemiology and Public Health, University of Ottawa, Room 101, 600 Peter Morand Crescent, Ottawa, ON, K1G 5Z3, Canada.
| | - Brian Feagan
- Robarts Clinical Trials, Robarts Research, University of Western Ontario, London, Canada
- Department of Medicine, University of Western Ontario, London, Canada
- Department of Epidemiology and Biostatistics, University of Western Ontario, London, Canada
| | | |
Collapse
|
2
|
Deichsel EL, Tickell KD, Long JE, Jumbe NL, Rowhani-Rahbar A, Walson JL. Challenges in Assessing Combined Interventions to Promote Linear Growth. Am J Trop Med Hyg 2018; 98:1220-1223. [PMID: 29436344 PMCID: PMC5953351 DOI: 10.4269/ajtmh.17-0212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Despite the recognition of stunting as a public health priority, nutritional and nonnutritional interventions to reduce or prevent linear growth failure have demonstrated minimal impact. Investigators and policymakers face several challenges that limit their ability to assess the potential benefits of combining available interventions into a linear growth promotion package. We use two common but very different interventions, deworming and multiple micronutrient supplements, to illustrate barriers to recommending an optimal linear growth promotion package based on the currently available literature. These challenges suggest that combining individual- and population-based as well as model-based approaches would complement existing research using systematic review, meta-analysis, and factorial randomized trials, and help integrate existing fields of research to inform the development of optimal linear growth promotion packages for children living in resource-limited settings.
Collapse
Affiliation(s)
- Emily L Deichsel
- Department of Epidemiology, University of Washington, Seattle, Washington
| | - Kirkby D Tickell
- Department of Global Health, University of Washington, Seattle, Washington.,Childhood Acute Illness & Nutrition Network (CHAIN), Nairobi, Kenya
| | - Jessica E Long
- Department of Epidemiology, University of Washington, Seattle, Washington
| | | | - Ali Rowhani-Rahbar
- Department of Epidemiology, University of Washington, Seattle, Washington.,Department of Pediatrics, University of Washington, Seattle, Washington
| | - Judd L Walson
- Department of Epidemiology, University of Washington, Seattle, Washington.,Department of Global Health, University of Washington, Seattle, Washington.,Department of Medicine, University of Washington, Seattle, Washington.,Department of Pediatrics, University of Washington, Seattle, Washington.,Childhood Acute Illness & Nutrition Network (CHAIN), Nairobi, Kenya
| |
Collapse
|