Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium.
Center for Health Technology Assessment, Semmelweis University, Budapest, Hungary; Syreon Research Institute, Budapest, Hungary.
Value Health. 2024 May;27(5):543-551. doi: 10.1016/j.jval.2024.01.018.
A systematic literature review undertaken by the ISPOR Biosimilar Special Interest Group highlighted that limited guidance exists on how to assess biosimilars value and on appropriate economic evaluation techniques. This study described current health technology assessment (HTA) agency approaches for biosimilar value assessment.
Semi-structured interviews (n = 16) were carried out with HTA experts in Africa, America, Asia, Australia, and Europe to investigate current HTA practices for biosimilars. Data categorization was based on a thematic analysis approach. Findings from the qualitative data analysis were interpreted in view of relevant published literature.
Our research suggests that in systems in which frameworks for biosimilar regulatory approval are well established, HTA agencies can accept the regulators' comparability exercise, and reimbursement decisions can generally be based on price comparisons. This approach is accepted in practice and allows streamlining of biosimilars value assessment. Nevertheless, conducting HTAs for biosimilars can be relevant when (1) the originator is not reimbursed, (2) the biosimilar marketing authorization holder seeks reimbursement for indications/populations, pharmaceutical forms, methods and routes of administration that differ with respect to the originator, and (3) a price premium is sought for a biosimilar based on an added-value claim. Further, HTA agencies' role conducting class-review updates following biosimilar availability can support greater patients' access to biologics.
Internationally, there are differences in how national competent authorities on pricing and reimbursement of pharmaceuticals perceive HTA's role for biosimilars. Therefore, HTA agencies are encouraged to issue clear guidance on when and how to conduct HTAs for biosimilars, and on which economic techniques to apply.
ISPOR 生物类似药特殊兴趣小组进行的系统文献回顾强调,对于如何评估生物类似药的价值以及适当的经济评估技术,目前的指导有限。本研究描述了当前卫生技术评估(HTA)机构评估生物类似药价值的方法。
对来自非洲、美洲、亚洲、澳大利亚和欧洲的 HTA 专家进行了半结构化访谈(n=16),以调查生物类似药的当前 HTA 实践。数据分类基于主题分析方法。定性数据分析的结果根据相关已发表文献进行解释。
我们的研究表明,在生物类似药监管批准框架已经完善的系统中,HTA 机构可以接受监管机构的可比性研究,报销决策通常可以基于价格比较。这种方法在实践中被接受,并允许简化生物类似药的价值评估。然而,当(1)原研药未获得报销,(2)生物类似药营销授权持有人寻求针对与原研药不同的适应证/人群、药物剂型、方法和给药途径的报销,以及(3)基于附加值主张对生物类似药寻求溢价时,进行生物类似药的 HTA 可能是相关的。此外,HTA 机构在生物类似药可用后进行类别审查更新的作用可以支持更多患者获得生物制剂。
在国际上,各国药品定价和报销主管部门对 HTA 评估生物类似药的作用的看法存在差异。因此,鼓励 HTA 机构发布关于何时以及如何进行生物类似药 HTA 以及应用哪些经济技术的明确指南。