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

Expert Rev Pharmacoecon Outcomes Res. 2020 Dec;20(6):653-659. doi: 10.1080/14737167.2019.1667232. Epub 2019 Sep 18.


Objectives: Utilization of multisource biological (off-patent originator and its biosimilar) medicines can improve the efficiency of resource allocation by 1) generating savings while maintaining health outcomes or 2) increasing the number of patients treated with more affordable treatments. This study evaluates the efficiency of the Hungarian biosimilar drug policy on the case of biosimilar infliximab. Methods: We analyzed the utilization of biologicals in all reimbursed indications of infliximab including initial therapy of new patients and switching patterns retrospectively based on patient-level payer's data between September 2012 and December 2016. Results: Despite the economic rationale, patent expiry did not manifest in increased utilization of multisource infliximab in an access-restricted environment: 1) Patients previously treated with original biologicals were switched mainly to other original biologicals instead of more affordable biosimilar alternatives. 2) Although some treatment-naive patients started on more affordable multisource infliximab with price competition, the majority of new patients started on other original biologicals with monopolistic price. Conclusion: Policy tools and measures should be developed to facilitate first-line use of multisource biologicals for treatment-naive patients and promoting the use of more affordable multisource biologicals in case of switching.

Keywords: Biosimilar policy; drug utilization; infliximab; patient access; therapy switch.

MeSH terms

  • Biological Products / administration & dosage*
  • Biological Products / economics
  • Biosimilar Pharmaceuticals / administration & dosage*
  • Biosimilar Pharmaceuticals / economics
  • Drug Substitution / economics
  • Drug Substitution / statistics & numerical data*
  • Health Policy
  • Health Services Accessibility
  • Humans
  • Hungary
  • Infliximab / administration & dosage*
  • Infliximab / economics
  • Insurance, Health, Reimbursement / statistics & numerical data
  • Longitudinal Studies
  • Patents as Topic
  • Resource Allocation
  • Retrospective Studies


  • Biological Products
  • Biosimilar Pharmaceuticals
  • Infliximab