Paying hospitals to cut the drugs budget

HSE has introduced a new, incentivsed scheme to increase the use of biosimilars in hospitals

Efforts to pull together a national policy on biosimilars remain stymied somewhere in the Department of Health but at least some moves are finally being made to tap the potential for cutting the State's medicines budget.

Biosimilars are like-for-like versions of expensive new generation biologic drugs that have come off patent. While not generics, which are identical copies of older drugs, biosimilars act in the same way and with the same safety profile as their branded rivals.

But take-up of biosimilars in the Irish health system has been painfully slow, held back by the lack of Government encouragement and inertia among medical practitioners.

It has become an increasingly contentious issue for drug companies – torn between promoting their own branded products but also looking at the State to create financial headroom to purchase expensive new therapies.


The issue has been highlighted by the failure of Spinraza – the only approved therapy in Europe for a rare and often fatal muscle-wasting disease, spinal muscular atrophy, that affects children in particular – to secure approval for use in Ireland recently at the second time of asking.

Now, the HSE has moved to incentivise consultants to use biosimilars for two of the most expensive drugs in the medicines budget – rheumatoid arthritis therapies Humira and Enbrel.

Doctors are being offered a €500 incentive for every new patient prescribed biosimilar alternatives or for existing patients who are transferred to the lower cost therapies.

The money will go back into the hospitals to help bulk out stretched budgets.

From Saturday, consultants will have to use an online high-tech hub to prescribe for the conditions. The biosimilar options will be among the default options. It is understood that consultants, who want to continue prescribing the more expensive brand name drugs, will be forced to take a more complex and labour intensive process.

It’s a small step but a step nonetheless in the right direction.

* The headline on this article was amended on June 1st, 2019