Is the Availability of Biosimilar Adalimumab Associated with Budget Savings? A Difference-in-Difference Analysis of 14 Countries

IF 5.4 2区医学 Q1 IMMUNOLOGY

BioDrugs Pub Date : 2023-12-08 DOI:10.1007/s40259-023-00636-z

Hyunjung Woo, Gyeongseon Shin, Donghwan Lee, Hye-Young Kwon, SeungJin Bae

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Abstract

Objective

The aim was to assess the influence of the presence of biosimilar adalimumab on adalimumab budget savings in 14 high- and upper-middle-income countries.

Methods

This study analyzed Multinational Integrated Data Analysis System (MIDAS)-IQVIA data from the fourth quarter (Q4) of 2018 to the Q4 of 2019, comparing adalimumab expenditure (in United States dollars) and consumption (in standard units [SU]) across 14 countries (Australia, Austria, Brazil, Canada, France, Germany, Italy, Japan, Korea, Singapore, South Africa, Spain, Sweden, and Taiwan). The countries were divided into two groups based on the availability of adalimumab biosimilars during the study period. A difference-in-difference design was employed to analyze the groups, focusing on changes from Q4 2018 to Q4 2019. Additionally, changes in adalimumab expenditure were decomposed into price, quantity, and drug mix during the study period.

Results

Among countries with adalimumab biosimilars, there was a significant decrease in expenditure (− $371.0 per gross domestic product per capita; p = 0.03) over four quarters, while the consumption significantly increased (1.0 SU per 1000 population; p = 0.02). This was consistent with visual observations and differed from countries without adalimumab biosimilar. Sensitivity analysis with a narrowed list of countries (12 high-income countries) showed a consistent trend. Adalimumab expenditure decreased by 14% during the study period in countries where adalimumab biosimilars were available, mainly due to the price changes (P_t = 0.85; − 15%) and the drug-mix effect (ε_t = 0.88; − 12%). Yet, adalimumab expenditure (E_t = 1.04; +4%) changed in a quantity-dependent manner (Q_t = 1.06; +6%) in countries where adalimumab biosimilars were absent.

Conclusion

The availability of biosimilars was associated with a decrease in adalimumab expenditure without compromising the consumption of adalimumab.

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阿达木单抗生物仿制药的供应与预算节省有关吗？对14个国家的差异分析

目的评估生物仿制药阿达木单抗的出现对14个高收入和中上收入国家阿达木单抗预算节省的影响。方法本研究分析了2018年第四季度（Q4）至2019年第四季度的多国综合数据分析系统（MIDAS）-IQVIA数据，比较了14个国家（澳大利亚、奥地利、巴西、加拿大、法国、德国、意大利、日本、韩国、新加坡、南非、西班牙、瑞典和台湾）的阿达木单抗支出（以美元计）和消费量（以标准单位[SU]计）。根据研究期间阿达木单抗生物仿制药的供应情况，这些国家被分为两组。采用差异设计对各组进行分析，重点关注从2018年第四季度到2019年第四季度的变化。此外，在研究期间，阿达木单抗支出的变化被分解为价格、数量和药物组合。结果在拥有阿达木单抗生物仿制药的国家中，四个季度的支出显著减少（人均国内生产总值-371.0美元；p = 0.03），而消费量显著增加（每千人1.0 SU；p = 0.02）。这与肉眼观察结果一致，并与没有阿达木单抗生物类似药的国家有所不同。缩小国家范围（12 个高收入国家）的敏感性分析显示了一致的趋势。在研究期间，有阿达木单抗生物类似物的国家的阿达木单抗支出减少了14%，主要原因是价格变化（Pt = 0.85；- 15%）和药物组合效应（εt = 0.88；- 12%）。然而，在没有阿达木单抗生物仿制药的国家，阿达木单抗的支出（Et = 1.04; +4%）以数量依赖的方式发生了变化（Qt = 1.06; +6%）。

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来源期刊

BioDrugs 医学-免疫学

CiteScore

12.60

自引率

2.90%

发文量

审稿时长

>12 weeks

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