Abstract

The biosimilar switching project was carried out in the Rheumatology and Gastroenterology departments in Princess Alexandra Hospital. Patients on anti TNF medication Infliximab were first targeted. The purpose of the project was switching the original branded Infliximab Remicade to the biosimilar infliximab Remsima for patients with Rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis and irritable bowel disease. The next medication switched was Enbrel (etanercept) to its biosimilar Benepali for Rheumatology patients. The project was led by specialist nurses and pharmacists with the clinical backing of Rheumatology and Gastroenterology Consultants. All patients on Remicade and Enbrel were expected to be switched to biosimilars as part of a cost saving initiative within the Trust. This was also supported by the two local CCG’s so that gain shared could be split between both NHS and CCG organisations. Letters regarding the switches were sent to patients and a Biosimilar helpline was generated to aid patients with any queries. Rheumatology patients were contacted and invited to attend introductory clinics where the discussion of switching took place and consent was taken. Patients were seen at 6–8 weeks post switch to review bloods and determine how they were responding to the biosimilar. 13 Remsima patients have responded well apart from two patients who had to switch back due to loss of disease control. 82 patients were consented to switch to benepali with 12 unwilling due to being on a different strength injection or due to their own concerns regarding disease control. However at present around 10% of benepali patients have experienced side effects. The main impact of change is financial benefit and cost saving for switching to biosimilars. But patient safety and engagement is paramount and ensures that patients are kept safe and continue to live normal lives and remain in remission with active disease control.