Cost minimization and switching management of reference products and their biosimilars in the Brazilian private health system: the case of Unimed Maringá

Abstract

Introduction: The use of biological drugs has been employed in the treatment of patients in several therapeutic areas, including oncology, rheumatology, endocrinology, and gastroenterology and Immunobiological therapies has contributed to rising healthcare costs. Adoptance of biosimilars are a global strategy to encourage market competition and expand patient access to treatments at the same time maintaining the efficacy and safety equivalent to reference products. Material and methods: Unimed Maringá has adopted a management system for switching reference products and biosimilars based on three pillars: establishment of continuing education for health professionals on biosimilars, use of protocols by disease and adequate patient profile for exchanges and adoption of general principles for the Acquisition of Biosimilar Products. Results: From January to August 2023, there were 547 patients under autoimmune treatment, of which 81.8% were using reference medication, 11.2% were using reference drugs that had biosimilars, and only 5.6% were already using biosimilars. The estimated reduction in treatment costs for 44 patients between September 1 and December 31, 2023 was 55.9%. The total cost reduction in drug consumption of 63 patients undergoing autoimmune treatment in the period between September and December 2023 was R$ 708,995.78. Conclusions: The adoptance of biosimilars by the payer was able to minimize the eventual litigation that occurs between payers, patients and physicians during the switching process. The total amount of cost reduction in the consumption of medicines by 63 patients being treated for autoimmune diseases in the period between September and December 2023 was R$ 708,995.78.