In 2018, NHS hospitals spent over £400m on Adalimumab, a biological medicine used to treat rheumatoid arthritis, inflammatory bowel disease and psoriasis. This level of spend made it the single medicine on which the NHS spent the most money. In October 2018, the UK patent for the originator Adalimumab product expired and biosimilar alternatives became available.
Edge Health was asked by the Medicines Policy Division of NHS England to help model pricing and potential savings scenarios for Adalimumab as part of a new supply framework which included these new biosimilars as well as the originator product.
The success of the framework depended on supporting and incentivising clinicians to switch patients to the best value biological medicine if it was clinically appropriate to do so. To support this, NHS England set a reference price for Adalimumab and awarded market share to companies based on the competitiveness of the price offered by the supplier. Edge Health analysed a range of complex pricing options to support the setting of this reference price and we further analysed the expected outcomes for providers, commissioners and industry to determine how to get best value for taxpayers and the NHS.
Edge Health’s support was critical in helping NHS England to develop the policy and price for Adalimumab across the NHS in England and realise over £290m of savings – significantly higher than had been expected.