Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea.
College of Pharmacy, Chung-Ang University, Seoul, Korea.
J Korean Med Sci. 2021 May 24;36(20):e143. doi: 10.3346/jkms.2021.36.e143.
We aimed to examine the uptake of infliximab and etanercept biosimilars in patients with rheumatoid arthritis (RA) and its economic implication for healthcare expenditure.
Using Korean Health Insurance Review and Assessment Service National Patient Samples, we extracted RA patients who used biologic disease modifying anti-rheumatic drugs (bDMARDs) between 2009 and 2018. Descriptive statistics were used to explain the basic features of the data. We calculated the proportion of users of each bDMARD among total patients with bDMARDs half-yearly. We assessed changes in the utilization proportions of bDMARDs including 4 tumor necrosis factor inhibitors (TNFis) and 2 non-TNFis, which have been approved for RA in Korea: etanercept, infliximab, adalimumab, golimumab, tocilizumab, and abatacept, and analyzed the changes in market share of biosimilars among the bDMARDs after their introduction. Overall trends of medical costs for each bDMARD were presented over the 10-year period.
Since the introduction of the biosimilar TNFis in 2012, the proportion of their use among bDMARDs steadily increased to 15.8% in 2018. While there has been a gradual increase in the use of biosimilar TNFis, the use of the corresponding originators has been decreasing. The introduction of biosimilar TNFis has resulted in a decrease in the medical costs of patients using either originator or biosimilar TNFis.
In Korea, the proportional use of biosimilar TNFis has gradually increased since their introduction. The availability of less expensive biosimilar TNFis seems to have brought about a decrease in the medical costs of users of the originators.
本研究旨在评估类风湿关节炎（RA）患者中英夫利昔单抗和依那西普生物类似药的使用情况及其对医疗支出的经济影响。
利用韩国健康保险审查和评估服务国家患者样本，提取 2009 年至 2018 年期间使用生物制剂的 RA 患者。使用描述性统计数据解释数据的基本特征。我们计算了每半年每种生物制剂在所有生物制剂患者中的使用比例。评估了包括已在韩国批准用于 RA 的 4 种肿瘤坏死因子抑制剂（TNFis）和 2 种非 TNFis 在内的生物制剂的使用比例的变化：依那西普、英夫利昔单抗、阿达木单抗、戈利木单抗、托珠单抗和阿巴西普，并分析了生物类似物在其上市后在生物制剂市场份额中的变化。展示了每种生物制剂在 10 年内的医疗费用总体趋势。
自 2012 年生物类似物 TNFis 上市以来，其在生物制剂中的使用比例稳步上升，2018 年达到 15.8%。虽然生物类似物 TNFis 的使用逐渐增加，但相应原研药的使用却在减少。生物类似物 TNFis 的引入导致使用原研药或生物类似物 TNFis 的患者的医疗费用降低。
在韩国，自生物类似物 TNFis 上市以来，其使用比例逐渐增加。较便宜的生物类似物 TNFis 的出现似乎降低了原研药使用者的医疗费用。
