Huge drug discount astonishes

NORWAY - BERGEN/OSLO (DAGENS MEDISIN/MEDICINE TODAY): There has been great excitement ahead of this year's tender for drugs by tumor necrosis factor (TNF) in Norway.
Thursday the Norwegian Drug procurement cooperation (LIS) published
the Norwegian national hospital tender for the infliximab biosimilar Inflectra/Remisima.
As last year's tender became historical when the Norwegian authorities for the first time recommended a biosimilar drug rather than the original - this year's price reduction offered by Orion Pharma astonishes the industry as well as the health care professionals.
Last year's discount proposed in Norway was 39 percent: Orion Pharma outdistanced pharmaceutical giant MSD/Merck's bestseller Remicade with its biosimilar drug Remsima (infliximab).
This year Orion Pharma proposed a 72 percent price reduction for  Remsima, an offer at a 69 percent lower cost than the price offered by MSD/Merck for their Remicade.
- It's a far lower price than many had anticipated. If this is the price that is going to apply in other countries, many more patients will have access to this type of medicine, says Torfinn Aanes, head of LIS - the Norwegian Drug procurement cooperation.
Dr. Steinar Madsen, medical director at the Norwegian Medicines Agency, who is a well known proponent of biosimilars, says he is surprised to see the large discounts on the  biosimilar infliximab.
– I had hoped to see discounts around 50 percent, but I did not anticipate a 72 percent price reduction. Infliximab patents expires in the rest of Europe in February 2015. With the prices we have seen today, the biosimilar infliximab will probably be a gamechanger in Europe, he says.
–  I guess the originator industry is quite worried. The most expensive TNF-inhibitors are now more than five times as costly as Remsima in Norway. In addition, we see that the price of some other TNF-inhibitors have been considerably reduced, probably in an attempt to compete for market shares against Remsima, says Madsen.
 – This illustrates one important aspect of biosimilars, their chilling effect on prices in general. It will be hard to launch similar drugs, whether biologicals or small molecular drugs at a substantially higher price.  But above all, this is a great day for our patients, as we will be able to extend treatment to many more in Europe.

• Norway have a system with budget for bDMARDS (biological disease-modifying anti-rheumatic drugs within the health care)

• An annual tender system has created opportunities for  lowering the costs of such drugs. Each company is invited to offer a price for their own product(s) for the following  year. A committee is calculating the annual cost for the first year on different indications based on the Summary of  Product  Characterstics (SPC) for  each drug

• Biosimilar infliximab (Remsima and Inflectra) was approved by the European Medicines Agency (EMA) and the Norwegian health authorities in the fall 2013.