The impact of an ‘evergreening’ strategy nearing patent expiration on the uptake of biosimilars and public healthcare costs: a case study on the introduction of a second administration form of trastuzumab in The Netherlands

Abstract In this paper, we explore dynamic market share and public healthcare costs of trastuzumab’s evergreening (subcutaneous) variant during introduction of trastuzumab’s competitive biosimilar variants in the Netherlands. We used a time series design to assess dynamic market share of trastuzumab’s evergreening variant after introducing trastuzumab’s biosimilar variants, focusing on the number of treatments and patients. The public healthcare costs of this evergreening strategy were estimated using administrative claims data. Our results show that the original trastuzumab was completely rep... Mehr ...

Verfasser: Kirshner, Ghyli
Makai, Peter
Brouns, Chiara
Timmers, Lonneke
Kemp, Ron
Dokumenttyp: Artikel
Erscheinungsdatum: 2024
Reihe/Periodikum: The European Journal of Health Economics ; ISSN 1618-7598 1618-7601
Verlag/Hrsg.: Springer Science and Business Media LLC
Sprache: Englisch
Permalink: https://search.fid-benelux.de/Record/base-27627092
Datenquelle: BASE; Originalkatalog
Powered By: BASE
Link(s) : http://dx.doi.org/10.1007/s10198-023-01648-w

Abstract In this paper, we explore dynamic market share and public healthcare costs of trastuzumab’s evergreening (subcutaneous) variant during introduction of trastuzumab’s competitive biosimilar variants in the Netherlands. We used a time series design to assess dynamic market share of trastuzumab’s evergreening variant after introducing trastuzumab’s biosimilar variants, focusing on the number of treatments and patients. The public healthcare costs of this evergreening strategy were estimated using administrative claims data. Our results show that the original trastuzumab was completely replaced by the subcutaneous and biosimilar variants. The uptake of the subcutaneous form peaked at 50% market share but after the introduction of biosimilars progressively reduced to a market share of 20%, resulting in a more competitive market structure. The public healthcare costs for trastuzumab significantly decreased after the introduction of the biosimilars. After the introduction of the biosimilars, a substantial price drop is visible, with the subcutaneous version, still under patent, also falling sharply in price but less strongly than the iv/biosimilar version. As the costs are publicly funded, we recommend a more explicit societal debate to consider if the potential benefits of subcutaneous Herceptin ® (and other similar medicines) are worth the additional costs, and at which price it should be reimbursed as the part of the benefit package.