Influence of biosimilar infliximab launch on the utilization pattern of biological medicines: the case of Hungary

Figures & data

Table 1. Number of active biological substances in the reimbursed indications of infliximab

Cluster	Number of reimbursed active biological substances	List of reimbursed active biological substances	Indication
Cluster 1	Infliximab and one other original biological	infliximab adalimumab	Ulcerative Colitis Adult Crohn’s Disease Pediatric Crohn’s Disease
Cluster 2	Infliximab and at least three other original biologicals	infliximab adalimumab etanercept golimumab	Ankylosing Spondylitis Psoriatic Arthritis
		infliximab adalimumab etanercept ustekinumab	Psoriasis
		infliximab abatacept adalimumab certolizumab pegol etanercept golimumab rituximab tocilizumab	Rheumatoid Arthritis

Figure 1. Number of patients treated with biological medicines in the reimbursed indications of infliximab

Table 2. Average share of initial biological therapy for treatment-naive patients in different indications before and after patent expiry of infliximab

	Number of reimbursed biologicals	Indication	Originator infliximab (%)	Biosimilar infliximab (%)	Other patent protected biological(s) (%)
Before Patent Expiry 2013.01. – 2013.10.	Infliximab and one other original biological	Ulcerative Colitis	59.6	N/A	40.4
		Adult Crohn’s Disease	49.7		50.3
		Pediatric Crohn’s Disease	100.0		0.0
	Infliximab and at least three other original biologicals	Rheumatoid Arthritis	2.6		97.4
		Ankylosing Spondylitis	11.0		89.0
		Psoriasis	8.9		91.1
		Psoriatic Arthritis	6.3		93.8
After Patent Expiry 2013.11. – 2016.12.	Infliximab and one other original biological	Ulcerative Colitis	13.5	50.3	36.3
		Adult Crohn’s Disease	14.3	37.0	48.7
		Pediatric Crohn’s Disease	17.1	18.4	64.6
	Infliximab and at least three other original biologicals	Rheumatoid Arthritis	0.4	1.2	98.4
		Ankylosing Spondylitis	1.1	4.1	94.8
		Psoriasis	1.4	1.6	97.0
		Psoriatic Arthritis	1.5	5.4	93.1

Table 3. Switching patterns in the reimbursed indications of infliximab (2012.09. – 2016.12.)

			IFX and one other original biological			IFX and at least three other original biologicals
			Ulcerative Colitis	Adults Crohn’s Disease	Pediatric Crohn’s Disease	Rheumatoid Arthritis	Ankylosing Spondylitis	Psoriasis	Psoriatic Arthritis
Total switch per indication			255	376	50	2194	672	489	278
Share of switch from infliximab among total switch (%)			76	70	70	9	23	23	16
Total switch from original infliximab			164	237	28	181	141	106	39
Share of switch from original infliximab (%)		to biosimilar infliximab	16	15	7	0	1	0	3
		to other original biological(s)	84	85	93	100	99	100	97
Total switch from other patented original biological(s)			36	79	12	2002	516	375	233
Share of switch (%)	from other original biological(s)	to original infliximab	25	34	0	1	4	5	2
		to biosimilar infliximab	75	66	100	1	10	4	12
	between other original biologicals		N/A	N/A	N/A	98	86	91	86