a

Biosimilars vs. Generic drugs

I'm a huge fan of the use of generic

drugs

anything that reduces the cost

patience reduces the

the NHS and certainly as an oncologist

what we've observed today is that the

NHS has been willing to use that money

to make the next lot of drugs available

and a little nice cannon does going for

a lot of criticism in many occasions

what it has been very successful in has

been in driving down the cost of drugs

and although most of this information is

absolutely top-secret I think most of us

are quite aware that you know these

drugs are being made available in the UK

cheaper than in other settings with that

said I think we when we move to

biosimilars rather than generic drugs we

have to be aware that antibodies are not

like making a chemical compound there

are differences in terms of the

glycosylation pattern of these molecules

the different way the protein might fold

and although and that's why they're

called similar and not absolutely

identical and clearly for a bias similar

to be made available some degree of

clinical trials have to be done -

showing equivalence but how do you

define equivalence and particularly

using chemo immunotherapy a lot of the

biosimilar antibodies are being released

as being equivalent to rituximab on the

basis of having looked at one indication

so I think many of us have some concerns

about is a biosimilar really going to be

absolutely as effective as the original

parent molecule I think time will tell

and of course unfortunately the savings

that you make for a biosimilar are

nowhere near what you make on a generic

so a generic imatinib compared to a

generic or bio similary tuckson lab has

a very different pace of pricing

differential my expectation is that you

know how how small a saving would be

required for four nice to move I think

pennies would be would be enough I think

any saving would be enough

to to move to move that to take out of

that field

I think if price came out of the

equation personally if I had access to

rituximab and biosimilar at exactly the

same price why would I change my

expectation as the biosimilars will come

in cheaper and I suspect within the NHS

I will have no choice but the antibody

that's available on the shelf by the

pharmacists will be the cheapest

available antibody and I think we'll be

watching very closely to ensure that we

are not seeing differences in outcome

from what we would expect