Clinical update

Biosimilars: a snapshot of latest developments

Biosimilars are a growing range of 'own brand' biological drugs that reproduce the effects of more expensive drugs

Biosimilars are a growing range of 'own brand' biological drugs that reproduce the effects of more expensive medicines

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Essential facts

Biosimilar medicines are made or derived from biological rather than chemical ingredients. As with standard medicines, when a patent expires on a ‘biologic’, other companies can reproduce it.

Biosimilar medicines offer wider access to innovative treatments and, according to the National Institute for Health and Care Excellence (NICE), a chance for the NHS to save money.

As Breast Cancer Care explains, copies of biologics are called ‘biosimilars’ because they are not identical to the original. They contain active substances, which means manufacturing exact copies is impossible. Instead, they are close imitations and will have met regulatory requirements in terms of safety and efficacy.   

Biosimilars are beginning to have an impact in cancer care but knowledge of them among some clinicians is limited.

What’s new?

Although biosimilars have been used in the NHS for some time, in cancer care and elsewhere, there is an increasing range developing. Among the latest is Pelmeg®, a pegfilgrastim biosimilar, used to reduce the duration of neutropenia and prevent febrile neutropenia, both common effects of cancer treatment.

The European Medicines Agency says studies have shown that Pelmeg produces similar levels of active substance in the body as the so-called ‘reference medicine’ Neulasta®. Its manufacturers say that as a single-dose formulation, Pelmeg is a lower-cost alternative.

What others say

NHS England says its staff will increasingly be involved in prescribing, administering and monitoring biosimilar medicines, and more patients will be eligible for treatment using biosimilars.

The NHS Cancer Vanguard argues that, although they are innovative, introducing biosimilars into NHS trusts can pose challenges because the drugs are not always fully understood. It has produced learning resources to help broaden clinicians’ knowledge.

And NICE argues that biosimilars have the potential to bring ‘considerable’ cost savings to the NHS, especially as they are often used to treat long-term conditions. 

What this means for cancer nurses

As biosimilars are developing rapidly, cancer care nurses should be prepared for questions from patients, particularly regarding biosimilars’ effectiveness in relation to more expensive drugs. The NHS Cancer Vanguard says biosimilars can be marketed at a lower price because they have a ‘less cost-intensive development programme’.

Specialist nurses may also be required to answer questions and provide information to other healthcare professionals.

Expert comment

Elaine Tomlins is a consultant nurse, University Hospital Southampton NHS Foundation Trust

Outside cancer, biosimilars have been around for a while. They’re fairly new as an anti-cancer primary therapy, but people don’t necessarily know about them.

The NHS is interested because biosimilars are much cheaper – about one quarter of the price of the original drug.

So far we’ve not found that patients experience them differently. Yet there is a difference in psychology because they are cheaper – they’re perceived to be ‘own brand’ drugs rather than a 'premium brand'.

Of course, that’s not the case but if someone relapses a couple of months after being switched to a biosimilar, they’re going to make the association and blame the drug.

So there’s a clear role for nurses in getting the facts out. Biosimilars are not a suboptimal therapy.

Daniel Allen is a freelance writer

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