Cost minimizing of the exchange between reference drug and its biossimilar: sustainability in the relationship treatment vs. supplementary health

Abstract

Objective: To evaluate the cost-minimization of the exchange between reference and biosimilar versions (BSM) of infliximab (IFX) in a health care provider with more than 500,000 lives. Method: Retrospective and descriptive study, followed by cost-minimization analysis among beneficiaries who used IFX, from January 1, 2016 to December 31, 2017. Was evaluated a possible exchange between drugs for the purpose to describe the economics of substitution. The undue payment of the technology, non-payment and justified glosses were established as exclusion criteria. After exclusion, the total expenses were calculated, adding product costs updated by the present value and infusion rates. Results and discussion: It was evidenced that 185 patients, totaling 1.441 releases, used IFX reference in the period evaluated. Of these, 31 releases were excluded due to the stipulated criteria. 1.410 releases were included. The analysis identified the use of 5.354 IFX reference bottles, for 12 specialties, totaling R$ 22.937.911,30 and average of R$ 16.268,02 (±R$ 4.257,91) per release and R$ 123.988,71 (±R$ 84.855,52) per patient. When the hypothetical change is applied, the adjusted cost amounts R$ 16.099.739,66, average R$ 11.418,26 (±R$ 2.975,37) and R$ 87.025,62 (±R$ 59.419,06) per release and beneficiary, respectively. A difference of R$ 6.838.171,64 in the supposed saving of resources. Conclusion: The economic analysis in the treatment with immunobiologicals shows significant relevance, since it contributes with the best use of the therapy of high cost allowing the sustainability of the health system. BSM drugs are presented as a cost-minimizing option compared to the reference treatment for supplementary health.