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Research Letter
July 20, 2020

Uptake of Infliximab Biosimilars Among the Medicare Population

Author Affiliations
  • 1Leonard D. Schaeffer Center for Health Policy & Economics, University of Southern California, Los Angeles
  • 2University of Southern California Sol Price School of Public Policy, Los Angeles
JAMA Intern Med. Published online July 20, 2020. doi:10.1001/jamainternmed.2020.3188

Biologics, large molecules produced in a living system, are one of the fastest growing segments of drug spending. In theory, biosimilars, highly similar copies of existing biologics, could lower costs. The first biosimilar to launch in the US, filgrastim-sndz, had strong adoption after just 2 years, capturing 40% of the market and lowering unit prices by 25%.1,2 However, unlike filgrastim, which treats acute indications, the second and third biosimilars to launch in the US addressed chronic conditions. Inflectra (infliximab-dyyb) and Renflexis (infliximab-abda), biosimilars to Remicade (infliximab), were approved for induction and maintenance of remission in lifelong conditions such as Crohn disease, ulcerative colitis, rheumatoid arthritis, psoriasis, and ankylosing spondylitis. Following starter doses at 0, 2, and 6 weeks, infliximab is administered once every 8 weeks. Although biosimilar versions are as safe and effective as the biologic, patients and physicians may be more reluctant to switch from a working biologic regimen in a chronic setting than an acute one.3-5 We examined the uptake of Inflectra and Renflexis and investigated physician switching behavior between biologic and biosimilar versions.

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