NHS set to save record £300 million on the NHS’s highest drug spend

The NHS is set to save a record £300 million after negotiating deals with five manufacturers on low cost versions of the health service’s most costly drug, Simon Stevens announced today.

The huge anticipated saving, the biggest in NHS history from a single drug negotiation, was unlocked by the introduction of ‘biosimilar’ versions of adalimumab are double previous estimates – and would pay for 11,700 more community nurses or 19,800 more breast cancer treatments for patients.

The deal should mean hospitals pay around a quarter of the more than £400 million each year they currently spend on adalimumab, which is used to treat severe hospital treated conditions such as rheumatoid arthritis, inflammatory bowel disease and psoriasis.

It also means that NHS England, working with NHS Improvement, is on course to deliver on its ambition to cut £300 million from the nation’s annual medicines bill by 2021 through greater use of best value biological medicines a year early.

Simon Stevens, NHS England’s chief executive, said: “As part of the NHS’s Long Term Plan we are ensuring every penny of extra investment is wisely spent. Harnessing the power of competition between drug companies, NHS England has now freed up hundreds of millions of pounds of savings to reinvest in patient care.  By working with patients and frontline clinicians we’ve now successfully negotiated the biggest ever set of savings on what was the NHS’s most costly drug.

“This is another example of how the smarter approach to biosimilar medicines in the UK and Europe gives patients and taxpayers a much better deal than they get in the United States.”

Adalimumab’s exclusive patent recently expired and the NHS has moved swiftly to drive strong competition between biosimilar manufacturers and the manufacturer of the originator brand, resulting in huge cost discounts.

NHS England has now accepted bids from four companies who manufacture biosimilar versions of the medicine – Amgen, Biogen, Mylan/Fujifilm Kyowa Kirin and Sandoz – as well as the manufacturer of the originator medicine, AbbVie.

More than 46,000 patients are being prescribed the drug today, available under the brand name Humira®, for severe hospital treated conditions such as rheumatoid arthritis, inflammatory bowel disease and psoriasis.

This is the latest example of ‘smart procurement’ by NHS England, supporting use of best value biologics across the country, whilst ensuring security of supply and providing patients and clinicians with treatment options. Close working between NHS England, patient groups and clinicians has been central to achieving this outcome.

Biosimilar versions of adalimumab are expected to be available to NHS patients in December. The ongoing use of Humira® may also continue where clinically appropriate or where it is the best value.

Clinicians are responsible for the decision, in consultation with the patient, to prescribe a biological medicine. NHS England expects patients switching to a biosimilar will have the same response as to the original medicine. To ensure plurality of supply each NHS region has a choice of medicines that they can prescribe – if the first choice medicine isn’t clinically appropriate for the patient they will have access to one of the other products available.

NHS England has issued guidance to Trusts and CCGs telling them that nine out of 10 new patients should be started on the best value biological medicine within three months of a biosimilar launch. At least 80% of existing patients should be switched to the best value biological medicine within 12 months.

In 2016/17 the NHS spent £18.2 billion on medicines, an increase of more than one third since 2010/11. In 2017/18, the NHS saved over £200 million by using best value biologics.

Adalimumab provides major clinical benefits to patients with severely debilitating diseases and NHS England will continue working closely with patient groups and clinical service providers during this period of transition to ensure that the very high quality of patient care is maintained.