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Monga A, Gagan, Jamwal P, Sharma S, Kaur A. Biosimilars: A Critical Review of Development, Regulatory Landscape, and Clinical Implications. AAPS PharmSciTech 2025; 26:46. [PMID: 39870890 DOI: 10.1208/s12249-025-03038-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2024] [Accepted: 12/26/2024] [Indexed: 01/29/2025] Open
Abstract
The biopharmaceutical industry has witnessed significant growth in the development and approval of biosimilars. These biosimilars aim to provide cost-effective alternatives to expensive originator biosimilars, alleviating financial pressures within healthcare. The manufacturing of biosimilars is a highly complex process that involves several stages, each of which must meet strict regulatory standards to ensure that the final product is highly similar to the reference biologic. To gain regulatory approval, biosimilars must undergo rigorous analytical characterization including in vitro assays, bioanalytical evaluations, and clinical similarity studies like pharmacokinetic (PK), pharmacodynamic (PD) assessments-to demonstrate safety, efficacy, quality comparability with reference products. Leading regulatory agencies such as the European Medicines Agency (EMA), the World Health Organization (WHO), and the United States Food and Drug Administration (US FDA) have established stringent guidelines for biosimilar evaluation and post-marketing surveillance. Despite this regulatory clarity, challenges around interchangeability, market exclusivity, and patent protection often delay market access and limit adoption, particularly in regions where automatic substitution is restricted. Case studies of biosimilars such as rituximab, adalimumab, filgrastim, and trastuzab reveal both advancements and ongoing hurdles in achieving broader market integration. The introduction of biosimilars has shown potential to reduce healthcare costs; for example, a recent analysis indicates a 20-30% cost reduction in the U.S. due to biosimilar adoption. As the biosimilar market expands, collaborative efforts among regulatory bodies, industry stakeholders, and healthcare providers are essential to enhance access to biologic therapies. This collaboration is poised to improve patient outcomes and catalyse transformative change in global healthcare systems.
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Affiliation(s)
- Ankit Monga
- School of Pharmaceutical Sciences, Delhi Pharmaceutical Sciences and Research University, New Delhi, India, 110017
| | - Gagan
- School of Pharmaceutical Sciences, Delhi Pharmaceutical Sciences and Research University, New Delhi, India, 110017
| | - Pragya Jamwal
- School of Pharmaceutical Sciences, Delhi Pharmaceutical Sciences and Research University, New Delhi, India, 110017
| | - Sumit Sharma
- School of Pharmaceutical Sciences, Delhi Pharmaceutical Sciences and Research University, New Delhi, India, 110017
| | - Amanpreet Kaur
- School of Pharmaceutical Sciences, Delhi Pharmaceutical Sciences and Research University, New Delhi, India, 110017.
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Long MD, Kane S, Beaulieu D, Abraham B, Zhang X, Mahadevan U. Use of Biosimilars to Infliximab During Pregnancy in Women With Inflammatory Bowel Disease: Results From the Pregnancy in Inflammatory Bowel Disease and Neonatal Outcomes Study. Clin Transl Gastroenterol 2024; 15:e00795. [PMID: 39665589 PMCID: PMC11671090 DOI: 10.14309/ctg.0000000000000795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2024] [Accepted: 11/15/2024] [Indexed: 12/13/2024] Open
Abstract
INTRODUCTION We aimed to compare pregnancy outcomes of women with inflammatory bowel disease using biosimilar vs originator infliximab (IFX). METHODS In a prospective cohort of pregnant women with inflammatory bowel disease, we collected characteristics, medications, pregnancy outcomes, and developmental milestones. We compared outcomes by IFX biosimilar or originator use via bivariate statistics. RESULTS A total of 100 pregnant women on originator IFX and 20 on biosimilar IFX were included. There were no differences in pregnancy complications between groups (48% vs 35%, P = 0.29). Infant developmental milestones were comparable at 12 months. DISCUSSION Biosimilar IFX is not associated with adverse pregnancy or infant outcomes.
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Affiliation(s)
- Millie D. Long
- University of North Carolina, Chapel Hill, North Carolina, USA
| | | | | | | | - Xian Zhang
- University of North Carolina, Chapel Hill, North Carolina, USA
| | - Uma Mahadevan
- University of California, San Francisco, California, USA
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Rana PJ, Deshmukh H, Shah U, Kumar V, Kanungo S, Singhal D, Mahapatra SK, Vakharia I, Jaiswal M, Gondane A, Vaidya P, Shahavi V, Shandilya H, Pawar D, Sharma A. Efficacy and Safety of Biosimilar Ranibizumab (OPTIMAB ®) versus Innovator Ranibizumab in Patients with Neovascular (Wet) Age-Related Macular Degeneration: A Double-Blind, Randomized, Multicenter, Phase III Study. Clin Ophthalmol 2024; 18:3071-3081. [PMID: 39493839 PMCID: PMC11531239 DOI: 10.2147/opth.s488866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2024] [Accepted: 10/23/2024] [Indexed: 11/05/2024] Open
Abstract
Objective This study aimed to compare efficacy, safety, and immunogenicity of the biosimilar ranibizumab in comparison with the Innovator Ranibizumab in treatment-naive patients with neovascular (wet) age-related macular degeneration (nAMD or wAMD). Materials and Methods This comparative, double blind, multicentre, Phase III clinical study randomized eligible patients in a 3:1 ratio to receive either OPTIMAB® (Alkem Laboratories Ltd./ Enzene Biosciences Ltd.) or Innovator Ranibizumab. Intravitreal injections of Innovator Ranibizumab (0.5 mg in 0.05 mL) and OPTIMAB® (0.5 mg in 0.05 mL) were administered every four weeks for 12 weeks (three doses). Primary efficacy endpoints included loss of <15 letters from baseline, gain of ≥15 letters from baseline in visual acuity, mean change in best corrected visual acuity (BCVA) from baseline, and change in central subfoveal thickness (CSFT) from baseline at week 12. Safety was assessed through monitoring of adverse events (AEs) and serious adverse events (SAEs) throughout the study. Results Overall, of the 152 patients randomized, 141 (92.8%) patients (mean age, 66.6 ± 9.37 years) completed the study. Percentage of patients who lost < 15 letters in BCVA at week 12 from baseline was comparable in both the groups (100.0%, each). On secondary end point analysis, the two groups had comparable mean changes in BCVA (OPTIMAB®, 11.8 ± 9.18; innovator ranibizumab, 12.9 ± 10.29; P = 0.5509); proportion of patients who gained ≥ 15 letters in visual acuity (OPTIMAB®, 32.18%; innovator ranibizumab, 25.74%; P = 0.4785) and mean change in CSFT (OPTIMAB®, -76.6 ± 89.03; Innovator ranibizumab, -73.1 ± 92.23 μm; P = 0.8422) at week 12 as compared to baseline. OPTIMAB® and innovator ranibizumab demonstrated comparable safety over the 12-week treatment period and no patient expressed anti-ranibizumab antibody in either group patient. Conclusion Biosimilar ranibizumab (OPTIMAB®) was non-inferior to innovator ranibizumab in terms of efficacy, safety, and immunogenicity in the patients of nAMD.
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Affiliation(s)
- Parth J Rana
- Department of Retina and Trauma Surgery, Netralaya Superspeciallity Hospital, Ahmedabad, Gujarat, India
| | - Himanshu Deshmukh
- Department of Retina; ‘Daulat’ Deshmukh Eye Hospital, Khaparde Gardens, Amravati, Maharashtra, India
| | - Urmil Shah
- Department of Retina, P.N. Desai Eye Hospital, Ahmedabad, Gujarat, 380052, India
| | - Vinod Kumar
- Department of Ophthalmology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Sanghamitra Kanungo
- Department of Retina, Kar Vision Eye Hospital, Bhubaneswar, Odisha, 751007, India
| | - Deepika Singhal
- Department of Ophthalmology, GMERS Medical College and Civil Hospital, Ahmedabad, Gujarat, India
| | - Santosh Kumar Mahapatra
- Department of Retina, JPM Rotary Club of Cuttack Eye Hospital and Research Institute, Cuttak, Odisha, 753014, India
| | - Ira Vakharia
- Department of Retina, Nirmal Hospital Pvt Ltd, Surat, Gujarat, 395002, India
| | - Mukesh Jaiswal
- Clinical Research Department, Alkem Laboratories Ltd., Lower Parel, Mumbai, India
| | - Ajitkumar Gondane
- Medical Affairs Department, Alkem Laboratories Ltd., Lower parel, Mumbai, India
| | - Pooja Vaidya
- Medical Affairs Department, Alkem Laboratories Ltd., Lower parel, Mumbai, India
| | - Vinayaka Shahavi
- Clinical Research Department, Alkem Laboratories Ltd., Lower Parel, Mumbai, India
| | - Harish Shandilya
- Global Product Development, IPM & Regulatory Affairs, Enzene Biosciences Ltd., Pune, India
| | - Dattatray Pawar
- Medical Affairs Department, Alkem Laboratories Ltd., Lower parel, Mumbai, India
| | - Akhilesh Sharma
- Medical Affairs and Clinical Research Department, Alkem Laboratories Ltd., Lower Parel, Mumbai, India
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Tank P, Vora S, Tripathi S, D'Souza F. Qualification of a LC-HRMS platform method for biosimilar development using NISTmab as a model. Anal Biochem 2024; 688:115475. [PMID: 38336012 DOI: 10.1016/j.ab.2024.115475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 12/27/2023] [Accepted: 01/26/2024] [Indexed: 02/12/2024]
Abstract
Biosimilars are a cost-effective alternative to biopharmaceuticals, necessitating rigorous analytical methods for consistency and compliance. Liquid chromatography coupled with high-resolution mass spectrometry (LC-HRMS) is a versatile tool for assessing key attributes, encompassing molecular mass, primary structure, and post-translational modifications (PTMs). Adhering to ICH Q2R1, we validated an LC-HRMS based peptide mapping method using NISTmab as a reference. The method validation parameters, covering system suitability, specificity, accuracy, precision, robustness, and carryover, were comprehensively assessed. The method effectively differentiated the NISTmab from similar counterparts as well as from artificially introduced spiked conditions. Notably, the accuracy of mass error for NISTmab specific complementarity determining region peptides was within a maximum of 2.42 parts per million (ppm) from theoretical and the highest percent relative standard deviation (%RSD) observed for precision was 0.000219 %. It demonstrates precision in sequence coverage and PTM detection, with a visual inspection of total ion chromatogram approach for variability assessment. The method maintains robustness when subjected to diverse storage conditions, encompassing variations in column temperature and mobile phase composition. Negligible carryover was noted during the carryover analysis. In summary, this method serves as a versatile platform for multiple biosimilar development by effectively characterizing and identifying monoclonal antibodies, ultimately ensuring product quality.
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Affiliation(s)
- Paresh Tank
- Analytical Chemistry Division of Zelle Biotechnology Research and Analytical Services, Zelle Biotechnology Pvt. Ltd., A-7 M.I.D.C., Mira Industrial Area, Western Express Highway, Mira Road, Thane, 401 104, India.
| | - Shruti Vora
- Analytical Chemistry Division of Zelle Biotechnology Research and Analytical Services, Zelle Biotechnology Pvt. Ltd., A-7 M.I.D.C., Mira Industrial Area, Western Express Highway, Mira Road, Thane, 401 104, India.
| | - Sarita Tripathi
- Analytical Chemistry Division of Zelle Biotechnology Research and Analytical Services, Zelle Biotechnology Pvt. Ltd., A-7 M.I.D.C., Mira Industrial Area, Western Express Highway, Mira Road, Thane, 401 104, India.
| | - Fatima D'Souza
- Analytical Chemistry Division of Zelle Biotechnology Research and Analytical Services, Zelle Biotechnology Pvt. Ltd., A-7 M.I.D.C., Mira Industrial Area, Western Express Highway, Mira Road, Thane, 401 104, India.
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Yuan J, Li M, Jiang X, Lu ZK. National Volume-Based Procurement (NVBP) exclusively for insulin: towards affordable access in China and beyond. BMJ Glob Health 2024; 9:e014489. [PMID: 38232994 PMCID: PMC10806927 DOI: 10.1136/bmjgh-2023-014489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 12/05/2023] [Indexed: 01/19/2024] Open
Abstract
Universal access to insulin remains a global public health challenge mainly due to its high price. After unsuccessful healthcare reforms attempting to lower insulin prices over the past several decades, the novel pooled procurement-also known as the national volume-based procurement (NVBP)was initiated exclusively for insulin in China. The NVBP exclusively for insulin represents a unique approach to conquering the challenges in the pooled procurement many low-income and middle-income countries face. In this paper, we described how the pooled procurement mechanism was implemented for insulin in China. Forty-two insulin products from 11 companies were procured, with a median price reduction of 42.08%. The procurement price ranged from US$0.35 to US$1.63 (¥2.35-¥10.97) per defined daily dose (DDD). The median procurement price per DDD was US$$0.54 (¥3.63) for human insulins and US$0.92 (¥6.18) for analogue insulin (p<0.001), respectively. A total of 32 000 medical facilities participated in the procurement, and the pooled demand for insulin was 1.61 billion daily doses, with an estimated saving of US$2.85 billion (¥19 billion) for the first year of the procurement agreement. Insulin affordability and accessibility improved substantially. This study reveals that the NVBP exclusively for insulin could effectively reduce insulin prices and improve access to this essential medicine. Even though the pooled procurement option looks efficient, its long-term impacts on the healthcare system should be closely monitored.
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Affiliation(s)
- Jing Yuan
- Minhang Hospital, School of Pharmacy, Fudan University, Shanghai, China
| | - Minghui Li
- The University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Xiangxiang Jiang
- College of Pharmacy, University of South Carolina, Columbia, South Carolina, USA
| | - Zhiqiang Kevin Lu
- College of Pharmacy, University of South Carolina, Columbia, South Carolina, USA
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Israilevich RN, Sharma K, Starr MR. Biosimilars for Retinal Diseases: A Review of the Literature. Int Ophthalmol Clin 2024; 64:129-139. [PMID: 38146886 DOI: 10.1097/iio.0000000000000509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2023]
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Bressler NM, Veith M, Hamouz J, Ernest J, Zalewski D, Studnička J, Vajas A, Papp A, Vogt G, Luu J, Matuskova V, Yoon YH, Pregun T, Kim T, Shin D, Oh I, Jeong H, Kim MY, Woo SJ. Biosimilar SB11 versus reference ranibizumab in neovascular age-related macular degeneration: 1-year phase III randomised clinical trial outcomes. Br J Ophthalmol 2023; 107:384-391. [PMID: 34656987 PMCID: PMC9985746 DOI: 10.1136/bjophthalmol-2021-319637] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 09/23/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND/AIMS To provide longer-term data on efficacy, safety, immunogenicity and pharmacokinetics (PK) of ranibizumab biosimilar SB11 compared with the reference ranibizumab (RBZ) in patients with neovascular age-related macular degeneration (nAMD). METHODS Setting: Multicentre. Design: Randomised, double-masked, parallel-group, phase III equivalence study. Patient population: ≥50 years old participants with nAMD (n=705), one 'study eye'. INTERVENTION 1:1 randomisation to monthly intravitreal injection of 0.5 mg SB11 or RBZ. Main outcome measures: Visual efficacy endpoints, safety, immunogenicity and PK up to 52 weeks. RESULTS Baseline and disease characteristics were comparable between treatment groups. Of 705 randomised participants (SB11: n=351; RBZ: n=354), 634 participants (89.9%; SB11: n=307; RBZ: n=327) completed the study until week 52. Previously reported equivalence in primary efficacy remained stable up to week 52 and were comparable between SB11 and RBZ. The adjusted treatment difference between SB11 and RBZ in full analysis set at week 52 of change from baseline in best-corrected visual acuity was -0.6 letters (90% CI -2.1 to 0.9) and of change from baseline in central subfield thickness was -14.9 µm (95% CI -25.3 to -4.5). The incidence of ocular treatment-emergent adverse events (TEAEs) (SB11: 32.0% vs RBZ: 29.7%) and serious ocular TEAE (SB11: 2.9% vs RBZ: 2.3%) appeared comparable between treatment groups, and no new safety concerns were observed. The PK and immunogenicity profiles were comparable, with a 4.2% and 5.5% cumulative incidence of antidrug antibodies up to week 52 for SB11 and RBZ, respectively. CONCLUSIONS Longer-term results of this study further support the biosimilarity established between SB11 and RBZ.
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Affiliation(s)
- Neil M Bressler
- Johns Hopkins Medicine Wilmer Eye Institute, Baltimore, Maryland, USA
| | - Miroslav Veith
- Department of Ophthalmology, University Hospital Kralovske Vinohrady, Prague, Czech Republic.,Department of Ophthalmology, Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Jan Hamouz
- Department of Ophthalmology, Third Faculty of Medicine, Charles University, Prague, Czech Republic.,University Hospital Kralovske Vinohrady, Praha, Czech Republic
| | - Jan Ernest
- Department of Ophthalmology, Central Military Hospital, Praha, Czech Republic
| | - Dominik Zalewski
- Diagnostic and Microsurgery Center of the Eye LENS, Olsztyn, Poland
| | - Jan Studnička
- Department of Ophthalmology, Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic.,University Hospital Hradec Kralove, Hradec Kralove, Královéhradecký, Czech Republic
| | - Attila Vajas
- Department of Ophthalmology, University of Debrecen, Debrecen, Hajdú-Bihar, Hungary
| | - András Papp
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Gabor Vogt
- Department of Ophthalmology, Hungarian Defence Forces Medical Centre, Budapest, Hungary
| | - James Luu
- Retina Consultants of Southern Colorado PC, Colorado Springs, Colorado, USA
| | - Veronika Matuskova
- Department of Ophthalmology, Faculty of Medicine, Masaryk University, Brno, Czech Republic.,University Hospital Brno, Brno, Czech Republic
| | - Young Hee Yoon
- Department of Ophthalmology, Asan Medical Center, Songpa-gu, Seoul, South Korea.,University of Ulsan College of Medicine, Songpa-gu, Seoul, South Korea
| | - Tamás Pregun
- Department of Ophthalmology, Bajcsy-Zsilinszky Hospital and Clinic, Budapest, Hungary
| | | | | | - Inkyung Oh
- Samsung Bioepis Co Ltd, Incheon, South Korea
| | | | | | - Se Joon Woo
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, South Korea .,Department of Ophthalmology, Seoul National University Bundang Hospital, Seongnam, South Korea
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Matli MC, Wilson AB, Rappsilber LM, Sheffield FP, Farlow ML, Johnson JL. The First Interchangeable Biosimilar Insulin: Insulin Glargine-yfgn. J Diabetes Sci Technol 2023; 17:490-494. [PMID: 34971335 PMCID: PMC10012380 DOI: 10.1177/19322968211067511] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
On March 23, 2020, all insulin products were reclassified as biologics instead of drugs under the Biological Price Competition and Innovation (BPCI) Act of 2009. This allows biosimilar insulin products to be manufactured when the patent expires for the reference biologic, sometimes called the originator or brand name product. A biosimilar product may not be substituted for the reference biologic at the pharmacy counter unless the biosimilar undergoes further switch trials to earn the designation as an interchangeable biosimilar. Insulin glargine-yfgn 100 units/mL is the first biosimilar insulin to attain interchangeable status with the reference insulin glargine. In the INSTRIDE 1 and INSTRIDE 2 trials, insulin glargine-yfgn has proven noninferiority regarding blood glucose reduction and adverse effect profile versus reference insulin glargine; even in the INSTRIDE 3 trial in which treatment of diabetes was switched between insulin glargine-yfgn and reference insulin glargine throughout the trial without statistically significant changes to glucose levels or adverse effects. Insulin glargine-yfgn may be substituted at the pharmacy counter without consultation with the prescriber, in accordance with state laws. In suit with other biosimilars, insulin glargine-yfgn's list price is significantly lower than other insulin glargine products. This increases market competition leading to decreases in costs of other insulin glargine products. Many patients who could not previously afford insulin therapy may now have significantly improved access to treatment. Providers will need education to increase awareness of these new biosimilars and interchangeable biosimilar insulin products, cost benefits, and substitution allowances.
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Affiliation(s)
| | - Andrea B. Wilson
- PharmD Candidate, College of Pharmacy,
Southwestern Oklahoma State University, Weatherford, OK, USA
| | | | - Farron P. Sheffield
- PharmD Candidate, College of Pharmacy,
Southwestern Oklahoma State University, Weatherford, OK, USA
| | - Miranda L. Farlow
- PharmD Candidate, College of Pharmacy,
Southwestern Oklahoma State University, Weatherford, OK, USA
| | - Jeremy L. Johnson
- Department of Pharmacy Practice,
College of Pharmacy, Southwestern Oklahoma State University, Weatherford, OK,
USA
- Department of Internal Medicine,
Oklahoma State University, Tulsa, OK, USA
- Jeremy L. Johnson, PharmD, BCACP, CDCES,
BC-ADM, Clinical Pharmacist/Diabetes Care and Education Specialist, Department
of Internal Medicine, Oklahoma State University, 717 S. Houston Ave., Suite 300,
Tulsa, OK 74127, USA.
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Ismail S, Abu Esba L, Khan M, Al-Abdulkarim H, Modimagh H, Yousef C. An Institutional Guide for Formulary Decisions of Biosimilars. Hosp Pharm 2023; 58:38-48. [PMID: 36644755 PMCID: PMC9837324 DOI: 10.1177/00185787221138007] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Biologics have changed the landscape for the management of many debilitating chronic diseases but account for a significant expenditure of medications globally. Fortunately, advances in technology paved the way for the introduction of biosimilars, which are highly similar to the originator biologics. In the quest to reduce the budget impact of biologics, organizations have begun to adopt biosimilars. Institutions evaluating biosimilars for inclusion in the hospital formulary must make informed formulary decisions by conducting a thorough review of key elements for evaluation of biosimilars and address the multidimensional aspects during the selection process of different biosimilar products. Therefore, we aim to present an institutional guide of these elements to inform formulary decisions. These key elements include biosimilar evaluation for formulary addition; regulatory approval; substitution, interchangeability, and switching; extrapolation; product characteristics, manufacturing, and supply chain issues; pharmacoeconomic evaluations; traceability, nomenclature, and coding; education; and pharmacovigilance.
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Affiliation(s)
- Sherin Ismail
- Pharmaceutical Care Department, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia
- King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
- University of North Carolina, Chapel Hill, NC, USA
| | - Laila Abu Esba
- King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
- College of pharmacy, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Pharmaceutical Care Department, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Mansoor Khan
- Pharmaceutical Care Department, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia
- King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
| | - Hana Al-Abdulkarim
- King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
- Doctoral School of Applied Informatics and Applied Mathematics, Óbuda University, Budapest, Hungary
- Drug Policy and Economic Center, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Hind Modimagh
- King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
- College of pharmacy, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Pharmaceutical Care Department, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Consuela Yousef
- King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
- Pharmaceutical Care Department, Ministry of National Guard Affairs, Dammam, Saudi Arabia
- King Saud bin Abdulaziz University for Health Sciences, Al Ahsa, Saudi Arabia
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Singh R, Chauhan R, Saxena A, Shah A, Mondal L, Bakhle D, Shah C, Shah A, Deoghare S, Krishnan N, Godse N. A prospective, randomized, parallel group, double blind, multicenter study to compare the efficacy, safety and immunogenicity of Lupin's Ranibizumab with Lucentis ® in patients with neovascular age-related macular degeneration. Indian J Ophthalmol 2022; 70:3008-3014. [PMID: 35918962 PMCID: PMC9672715 DOI: 10.4103/ijo.ijo_2118_21] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Purpose: The present study compares the efficacy, safety, and immunogenicity of Lupin’s biosimilar ranibizumab with that of Lucentis® in patients with neovascular age-related macular degeneration. Methods: This prospective, double-blind, multi-centric phase-III study was conducted across 19 centers in India. A total of 202 patients with neovascular age-related macular degeneration were randomized (1:1) to receive either Lupin’s biosimilar ranibizumab or Lucentis®, 0.5 mg, as an intravitreous injection once every month for 3 months. The primary efficacy endpoint was the proportion of patients who lost fewer than 15 letters from baseline in best-corrected visual acuity. The safety profile included assessment of adverse events, ophthalmic examination, physical and systemic examination, and vital parameters. The immunogenicity assessment was based on evaluation of anti-drug antibodies. Results: Overall, 174 patients (87 [86.14%] in each group) completed the study. The demographics and baseline characteristics were comparable between the treatment groups. The proportion of patients losing fewer than 15 letters from baseline best corrected visual acuity score in the study eye was comparable between two groups. The difference between Lupin’s ranibizumab and Lucentis® for the proportion of patients who lost fewer than 15 letters was within the predefined equivalence margin (intention-to-treat population: 1.0%; 95% confidence interval [CI], −3.3% to 5.4% and per protocol population: 1.2%; 95% CI, −3.2% to 6.4%). The incidence of treatment-emergent adverse events was comparable, and 11 (10.89%) patients in Lupin’s ranibizumab and 19 (18.81%) patients in Lucentis® group had at least one treatment-emergent adverse event. The immunogenicity incidence as assessed by proportion of patients with positive anti-drug antibodies was numerically lower in Lupin’s ranibizumab (4.95%) than Lucentis® (12.87%). Conclusion: Lupin’s biosimilar ranibizumab demonstrated therapeutic equivalence, desirable safety, and favorable immunogenicity profile compared to Lucentis®.
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Affiliation(s)
- Ramandeep Singh
- Professor, Department of Ophthalmology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Rohan Chauhan
- Vitreo Retinal Surgeon-Department of Ophthalmology, Rising Retina Clinic, Ahmedabad, Gujarat, India
| | - Ashish Saxena
- Consultant, Department of Ophthalmology, Kanoria Hospital and Research Center, Gandhinagar, Gujarat, India
| | - Anup Shah
- Consultant, Department of Ophthalmology, Dhadiwal Hospital, Nashik, Maharashtra, India
| | - Laxshmi Mondal
- Professor, Department of Ophthalmology, Regional institute of Opthalmology, Kolkata, West Bengal, India
| | - Dhananjay Bakhle
- Medical Research Department, Lupin Limited, Pune, Maharashtra, India
| | - Chirag Shah
- Medical Research Department, Lupin Limited, Pune, Maharashtra, India
| | - Arpit Shah
- Medical Research Department, Lupin Limited, Pune, Maharashtra, India
| | - Shashank Deoghare
- Medical Research Department, Lupin Limited, Pune, Maharashtra, India
| | | | - Neelima Godse
- Medical Research Department, Lupin Limited, Pune, Maharashtra, India
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Saunders H, Pham B, Loong D, Mishra S, Ashoor HM, Antony J, Darvesh N, Bains SK, Jamieson M, Plett D, Trivedi S, Yu CH, Straus SE, Tricco AC, Isaranuwatchai W. The Cost-Effectiveness of Intermediate-Acting, Long-Acting, Ultralong-Acting, and Biosimilar Insulins for Type 1 Diabetes Mellitus: A Systematic Review. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2022; 25:1235-1252. [PMID: 35341688 DOI: 10.1016/j.jval.2021.12.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 11/15/2021] [Accepted: 12/14/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVES The incidence of type 1 diabetes mellitus is increasing every year requiring substantial expenditure on treatment and complications. A systematic review was conducted on the cost-effectiveness of insulin formulations, including ultralong-, long-, or intermediate-acting insulin, and their biosimilar insulin equivalents. METHODS MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, HTA, and NHS EED were searched from inception to June 11, 2021. Cost-effectiveness and cost-utility analyses were included if insulin formulations in adults (≥ 16 years) with type 1 diabetes mellitus were evaluated. Two reviewers independently screened titles, abstracts, and full-text articles, extracted study data, and appraised their quality using the Drummond 10-item checklist. Costs were converted to 2020 US dollars adjusting for inflation and purchasing power parity across currencies. RESULTS A total of 27 studies were included. Incremental cost-effectiveness ratios ranged widely across the studies. All pairwise comparisons (11 of 11, 100%) found that ultralong-acting insulin was cost-effective compared with other long-acting insulins, including a long-acting biosimilar. Most pairwise comparisons (24 of 27, 89%) concluded that long-acting insulin was cost-effective compared with intermediate-acting insulin. Few studies compared long-acting insulins with one another. CONCLUSIONS Long-acting insulin may be cost-effective compared with intermediate-acting insulin. Future studies should directly compare biosimilar options and long-acting insulin options and evaluate the long-term consequences of ultralong-acting insulins.
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Affiliation(s)
- Hailey Saunders
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Ba' Pham
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Desmond Loong
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Sujata Mishra
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Huda M Ashoor
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Jesmin Antony
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Nazia Darvesh
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Silkan K Bains
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Margaret Jamieson
- Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Donna Plett
- Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Srushhti Trivedi
- Joint Centre for Bioethics, University of Toronto, Toronto, Ontario, Canada
| | - Catherine H Yu
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada; Division of Endocrinology and Metabolism, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Sharon E Straus
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Andrea C Tricco
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Ontario, Canada; Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Wanrudee Isaranuwatchai
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Ontario, Canada.
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Abstract
Subcutaneous MYL1501D insulin glargine 100 U/mL (hereafter referred to as MYL1501D insulin glargine) [Semglee®] is a long-acting human insulin analogue approved as a biosimilar of insulin glargine 100 U/mL (hereafter referred to as reference insulin glargine 100 U/mL) [Lantus®] in various countries, including those of the EU for the treatment of diabetes mellitus in patients aged ≥ 2 years, as well as Japan for diabetes where insulin therapy is indicated. MYL1501D insulin glargine has similar physicochemical characteristics and biological properties to those of EU- and US-sourced reference insulin glargine 100 U/mL, with the bioequivalence of pharmacodynamic and pharmacokinetic parameters between these agents shown in adults with type 1 diabetes. Once-daily MYL1501D insulin glargine demonstrated noninferior glycaemic efficacy to that of once-daily reference insulin glargine 100 U/mL in adults with type 1 or 2 diabetes, with its glycated haemoglobin-lowering benefits maintained over the longer-term (52 weeks) and unaffected by previous insulin exposure. Switching between MYL1501D insulin glargine and reference insulin glargine 100 U/mL did not appear to impact glycaemic efficacy in adults with type 1 diabetes. MYL1501D insulin glargine was well tolerated, demonstrating a safety and immunogenicity profile similar to that of reference insulin glargine 100 U/mL in patients with type 1 and 2 diabetes, and in those with type 1 diabetes switching between the two agents. As expected, hypoglycaemia was the most frequently reported treatment-emergent adverse event. Thus, MYL1501D insulin glargine provides an effective biosimilar alternative for patients requiring insulin glargine therapy.
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Affiliation(s)
- Sheridan M Hoy
- Springer Nature, Private Bag 65901, Mairangi Bay, Auckland, 0754, New Zealand.
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Rasmussen JT, Ipema HJ. Formulary Considerations for Insulins Approved Through the 505(b)(2) "Follow-on" Pathway. Ann Pharmacother 2018; 53:204-210. [PMID: 30122087 DOI: 10.1177/1060028018795834] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE To summarize formulary-relevant issues for follow-on insulins approved through the Food and Drug Administration (FDA) 505(b)(2) approval pathway (Basaglar and Admelog). DATA SOURCES A search of the MEDLINE database was performed for articles pertaining to clinical and formulary considerations for follow-on insulin products through July 2018. STUDY SELECTION AND DATA EXTRACTION All clinical trials used in the 505(b)(2) approval process for follow-on insulin glargine and insulin lispro products were included and summarized. DATA SYNTHESIS Follow-on insulin glargine and insulin lispro products have been recently approved as the first lower-cost alternatives to innovator insulin products. The follow-on insulins were approved via the 505(b)(2) pathway, making them neither generics nor biosimilars. Current data do not suggest any clinically relevant differences between the follow-on insulins and their respective innovator products. Clinicians should be aware that follow-on insulins will be reclassified as biologic products in the year 2020. Relevance to Patient Care and Clinical Practice: This article provides information about currently available follow-on insulin products that were approved through the 505(b)(2) pathway, including product characteristics and efficacy and safety data. These products will likely be considered for both clinical use and formulary placement because of their potentially lower cost compared with innovator products. CONCLUSIONS Follow-on insulin products approved through the 505(b)(2) pathway are supported by robust efficacy and safety data. As new follow-on insulins are approved and the regulatory change that will occur with these products in 2020 approaches, formulary decisions and clinical policies (eg, substitution) will continue to be revisited.
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Affiliation(s)
- Jack T Rasmussen
- 1 University of Illinois at Chicago College of Pharmacy, IL, USA
| | - Heather J Ipema
- 1 University of Illinois at Chicago College of Pharmacy, IL, USA
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Im GB, Bhang SH. Recent research trend in cell and drug delivery system for type 1 diabetes treatment. JOURNAL OF PHARMACEUTICAL INVESTIGATION 2018. [DOI: 10.1007/s40005-017-0380-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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