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Unlocking the potential of biosimilars to enable sustainability of European health care systems

Dan Cohen, vice president and head of the Biosimilars Unit for Europe, Canada and partner markets at Biogen

The global biologic medicines market was valued at over $338 billion in 2021[1] and accounts for 27 percent of the global pharmaceutical market by value[2][3]. This figure continues to grow at a significant pace[4]

In Europe, biologics represent 34 percent of medicine spending at list prices and reached €78.6 billion in 2021.[5] This percentage varied significantly across European countries therefore, managing this segment and its growth becomes a must for sustainable health care systems. The total European biosimilar market reached €8.8 billion in 2021[6], representing 3 percent of the total European pharmaceutical value[7][8].

Dan Cohen, vice president and head of the Biosimilars Unit for Europe, Canada and partner markets at Biogen, explores how biosimilars are central to safeguarding future health care innovation, and why their increased uptake can alleviate the burden on health care systems by offering cost savings and promoting earlier and better access to therapies.

Mr Cohen, you represent one of the leading biosimilar providers in Europe. What are your reflections on the biosimilar journey in Europe?

“Europe is at the forefront of the biosimilar opportunity. From a patient perspective, we have seen increased access to biologic medicines across several countries, in addition to the billions in savings at a time when budgets remain constrained by COVID-19. We are proud at Biogen to have partnered with health care systems across Europe, in 2021 Biogen alone generated €2.6 billion in savings[9]. To me, the re-investment of savings into improved care and expanded patient access to treatment is the essence of the biosimilars’ value proposition. Looking ahead, there are many disease areas with unmet needs that would benefit from biosimilars.”

Re-investment of savings into improved care and expanded patient access to treatment is the essence of the biosimilars’ value proposition.

Can you tell us more about the benefits biosimilars have brought to patients and our health care systems?

“Biosimilars are key components of a sustainable health care system. As a more cost-effective treatment option than their reference biologics[10], biosimilars make it possible for more patients to be treated while delivering savings that can be invested into innovation and additional services. Moreover, they can also bring financial relief in the aftermath of the COVID-19 pandemic. Health care systems have saved billions of euros with biosimilars — even though they represent just 3 percent of the total European pharmaceutical market by value today[11][12].  By stimulating competition, biosimilars have had a significant impact on the market that will continue to grow.”

Why is the potential of biosimilars not fully unlocked yet? What challenges did you identify and how can these be overcome?

“Biosimilars are helping us progress toward a more sustainable health care model. However, procurement and effective incentives for prescribers are critical hurdles. Further advocacy and effective prescriber incentives and support are required. Payers and providers should align on common objectives to encourage the uptake of biosimilars, while maintaining physician and patient choice. The long-term sustainability of the system may be at risk if the physician choice is removed by automatic pharmacy substitution without the involvement of a prescriber. In fact, due to the complexity of biosimilar treatments and their related administration devices, automatic pharmacy substitution could affect patient compliance with treatment and might even compromise traceability and pharmacovigilance.   

“Next, as more molecules lose exclusivity, we need to make sure that the regulatory approval processes support biosimilar competition. Current processes have been effective so far, but they may lead to extensive delays in approval as more biosimilars are developed. It is very important that the regulatory process is efficient and appropriately resourced to make the most of the biosimilars opportunity.”

A more cost-effective treatment option than their reference biologics, biosimilars make it possible for more patients to be treated.

We talk a lot about sustainability today what does it mean to the health care industry and what role do biosimilars play?

“In health care, ‘sustainability’ is a journey where all stakeholders, ideally, function effectively. It involves the creation of a system benefitting all stakeholders while focusing on patients, ultimately ensuring the longevity of the system itself.

“Sustainability is very much about balance. Balance between price discounts and policies supporting uptake, between price competition and non-price tendering criteria, but also between different stakeholders. Biosimilars can balance pharmaceutical spending, unlock savings for future innovation, and ultimately improve patient access.

“It is also essential that the totality of the system continues to incentivize sustainable market investment across Europe. The increased rapidity of price erosion for biosimilars launched in Europe further reinforces the requirements of beyond price criteria to become higher on the agenda and weighting of decisions on preferred providers. Ultimately, we need to ensure we achieve an optimal patient experience, including continuity of supply and support services to be maintained over the long term.”

Biosimilars can balance pharmaceutical spending, unlock savings for future innovation, and ultimately improve patient access.

What is the role of policymakers? What could they do to help European health care systems maximize the benefits of introducing biosimilars?

“Biosimilars sustainability is an important component of the overall sustainability of health care systems. Considering the EU Pharmaceutical Strategy’s emphasis on improving access to biosimilars, we support upcoming policies tailored to stimulate biosimilar competition[13].

“Policymakers and payers should ensure that pricing dynamics are led by competition, instead of mandatory price decreases, to ensure a steady price erosion across competitors. Therefore, we need procurement rules with sufficient guaranteed volume allowing multiple winners. “Awareness and education are the foundation for all policies: stakeholders should publicly advocate the benefits achieved, such as the number of additional patients treated, the new equipment purchased, or the scale of overall savings to be reinvested. The more we all track, calculate and communicate about the positive impact of biosimilars, the more effectively we can encourage their use and promote sustainable competition that will deliver long-term value.”


[1] Biologics Global Market Report 2022 thebusinessresearchcompany.com/report/biologics-global-market-report accessed September 2022

[2] Pharmaceuticals Global Market Report 2021: COVID-19 Impact and Recovery to 2030 https://www.researchandmarkets.com/reports/5292738/pharmaceuticals-global-market-report-2021 – accessed September 2022

[3] Biologics Global Market Report 2022 thebusinessresearchcompany.com/report/biologics-global-market-report accessed September 2022

[4] IQVIA The Impact of Biosimilar Competition in Europe 2021 https://www.iqvia.com/-/media/iqvia/pdfs/library/white-papers/the-impact-of-biosimilar-competition-in-europe-2021.pdf accessed September 2022

[5] IQVIA The Impact of Biosimilar Competition in Europe 2021 https://www.iqvia.com/-/media/iqvia/pdfs/library/white-papers/the-impact-of-biosimilar-competition-in-europe-2021.pdf accessed September 2022

[6] IQVIA The Impact of Biosimilar Competition in Europe 2021 https://www.iqvia.com/-/media/iqvia/pdfs/library/white-papers/the-impact-of-biosimilar-competition-in-europe-2021.pdf accessed September 2022

[7] Europe Pharmaceutical Market Size, Share & Trends Analysis Report By Product (Branded, Generic), By Type (Prescription, OTC), By Therapeutic Category, By Region, And Segment Forecasts, 2021 – 2028 https://www.grandviewresearch.com/industry-analysis/europe-pharmaceutical-market-report accessed September 2022

[8] IQVIA The Impact of Biosimilar Competition in Europe 2021 https://www.iqvia.com/-/media/iqvia/pdfs/library/white-papers/the-impact-of-biosimilar-competition-in-europe-2021.pdf accessed September 2022

[9] Biogen Q4 2021 Financial & Business Results https://investors.biogen.com/static-files/019bc8a4-527e-4565-a58b-91ef680630c1 accessed September 2022

[10] The cost-effectiveness of biosimilars and their future potential for the NHS, https://blogs.deloitte.co.uk/health/2021/05/the-cost-effectiveness-of-biosimilars-and-their-future-potential-for-the-nhs.html  accessed October 2022

[11] IQVIA The Impact of Biosimilar Competition in Europe 2021 https://www.iqvia.com/-/media/iqvia/pdfs/library/white-papers/the-impact-of-biosimilar-competition-in-europe-2021.pdf accessed September 2022

[12] Europe Pharmaceutical Market Size, Share & Trends Analysis Report By Product (Branded, Generic), By Type (Prescription, OTC), By Therapeutic Category, By Region, And Segment Forecasts, 2021 – 2028 https://www.grandviewresearch.com/industry-analysis/europe-pharmaceutical-market-report accessed September 2022

[13] Pharmaceutical Strategy for Europe 2020 https://health.ec.europa.eu/system/files/2021-02/pharma-strategy_report_en_0.pdf accessed September 2022



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