Lack of clinician engagement, patient resistance, and safety concerns were among the main barriers to biosimilars uptake, according to a survey of 134 clinical commissioning groups (CCGs) by NHS England.
And CCGs estimated that they made an average saving of around £475,000 in 2017/2018, from patients switching to biosimilars, with some saving up to £3.2m. In 2018/2019 average savings were estimated to be £1.1m, with maximum savings of £8.3m.
Based on the responses from CCGs, the average uptakes for etanercept, infliximab and rituximab were estimated to be between 52% and 69% (depending on the type of biosimilar) in 2017/2018. For etanercept, infliximab, rituximab and adalimumab, average uptake was predicted to be between 69% and 83% in 2018/2019.
A second survey of 20 NHS trusts found that trusts cited clinician engagement as less of a concern in terms of biosimilars uptake, behind financial agreements and staff resources.
The surveys revealed that, in many trusts, pharmacies take the lead in producing switch policies and the relevant clinical specialities are also involved in their development.
Neither survey identified whether patients were empowered or informed to request biosimilars, but the survey found that trusts were effective at engaging patients regarding medication changes, while pharmacy leads said that patients generally found biosimilar switching acceptable.
However, there were several reports that funding did not go to the relevant department in the trust for the work, which created a barrier for clinicians to motivate delivery. There were also consistent reports from trusts and CCGs about the impact of not having all the necessary elements, such as homecare and nursing support, in place at the initial launch of a biosimilar, resulting in delays and added complexity to switch programmes.
Overall, the survey highlighted several main areas where more focus was needed to support CCGs and trusts with biosimilars uptake, including a strategic national focus on patient engagement, procurement and homecare.