Tan She Hui, Goh Louise Gek Huang, Ong Benjamin Shao Kiat, Ng Darren Sze Guan, Lin Liang, Ng Raymond Chee Hui, Thong Bernard Yu-Hor, Ng Kwong
Agency for Care Effectiveness (ACE), Ministry of Health, 16 College Road, College of Medicine Building, Singapore, 169854, Singapore.
Division of Medical Oncology, National Cancer Centre Singapore, 30 Hospital Blvd, Singapore, 168583, Singapore.
Pharmacoecon Open. 2024 Sep;8(5):679-688. doi: 10.1007/s41669-024-00491-w. Epub 2024 Jul 23.
Healthcare sustainability is a global challenge. Various value-driven healthcare strategies have been implemented by Singapore's national health technology assessment (HTA) agency, the Agency for Care Effectiveness (ACE). Considering the high and growing expenditure on biologics, strategies have been implemented to drive the use of biosimilars. As Singapore has reached the 5-year mark since the subsidy listing of the first monoclonal antibody biosimilar infliximab, this review aimed to evaluate the impact of these strategies on the changes in adoption rates, utilisation, spending and cost savings for biosimilars in the public healthcare sector.
A retrospective cross-sectional study was conducted using aggregated drug utilisation data from all public healthcare institutions. Five monoclonal antibodies with biosimilars, namely infliximab, adalimumab, trastuzumab, rituximab and bevacizumab, were included in this study. The outcomes evaluated were the monthly trends for utilisation volume, proportion attributed to biosimilar use, and drug spending up to December 2022. The simulated cost savings associated with biosimilar adoption were also reported.
After subsidy implementation, an upward trend in biosimilar use and proportion attributed to biosimilar adoption was observed, while spending reduced substantially. The adoption rate of most biosimilars reached more than 95% within 1 year of listing. Drugs with more than one approved biosimilar brand at the time of subsidy listing reported substantial price reductions of over 80%. Overall, spending for the five monoclonal antibodies have significantly reduced after biosimilar subsidy listing, with an estimated cumulative cost savings of $136 million over 5 years.
Value-driven healthcare strategies implemented in Singapore's public healthcare institutions have contributed to high adoption rates of biosimilars and have improved affordable access through lower treatment costs. This in turn has led to significant cost savings to the healthcare system.
医疗保健的可持续性是一项全球性挑战。新加坡国家卫生技术评估（HTA）机构——医疗成效机构（ACE）已实施了各种价值驱动型医疗保健策略。鉴于生物制剂的支出高昂且不断增长，已实施相关策略来推动生物类似药的使用。由于自首个单克隆抗体生物类似药英夫利昔单抗补贴上市以来，新加坡已达到5年期限，本综述旨在评估这些策略对公共医疗保健部门生物类似药的采用率、使用情况、支出和成本节约变化的影响。
利用所有公共医疗机构的汇总药物使用数据进行了一项回顾性横断面研究。本研究纳入了五种有生物类似药的单克隆抗体，即英夫利昔单抗、阿达木单抗、曲妥珠单抗、利妥昔单抗和贝伐单抗。评估的结果是截至2022年12月的使用量月度趋势、生物类似药使用所占比例以及药物支出。还报告了与采用生物类似药相关的模拟成本节约情况。
补贴实施后，观察到生物类似药的使用及其在采用中所占比例呈上升趋势，而支出大幅下降。大多数生物类似药在上市1年内的采用率达到了95%以上。补贴上市时拥有一个以上获批生物类似药品牌的药物价格大幅降低了80%以上。总体而言，生物类似药补贴上市后，这五种单克隆抗体的支出显著减少，估计5年内累计成本节约1.36亿美元。
新加坡公共医疗机构实施的价值驱动型医疗保健策略促使生物类似药的高采用率，并通过降低治疗成本改善了可负担性。这反过来又为医疗保健系统带来了显著的成本节约。
