Background
Our Pharmacy and Healthcare Services team has worked closely with homecare teams in member trusts to support the rapid transition of suitable patients to a biosimilar product for Ustekinumab, brand name Stelara, offering potential cost savings of up to 70%.
Made or derived from living organisms, this biological, complex protein-based medicine is used to treat conditions such as plaque psoriasis, psoriatic arthritis and Crohn’s disease. In our region, the annual spend on this originator product is approximately £20 million.
With the patent on Stelara having recently expired and with the award of a new contract in September through NHS England Medicines, Procurement and Supply Chain (MPSC) framework, four Ustekinumab biosimilar product ranges are now available at a significant discount.
Biosimilars are new biological medicinal products developed to be similar to existing biological medicines. They contain a version of an active substance of an approved biological medicinal product, known as the reference product. Stelara is predominantly supplied to patients via homecare medicines services with patients receiving the medication, prescribed by their hospital prescriber and associated clinical service, direct to their home via a third-party service provider. Clinical services for this service are typically training for self-injection or ongoing administration, as required by the patient. These services are funded by the product manufacturer and can be accessed via the Hub’s Homecare Medicines Services framework.
Current NHSE Specialist Pharmacy Service (SPS) guidance is for patients receiving Stelara for ulcerative colitis to continue to be supplied Stelara until resolution of ongoing legal proceedings. All other Stelara patients can be switched to a biosimilar Ustekinumab product. General NHSE guidance supporting the safe, effective and consistent use of biosimilar medicines to benefit patients in the NHS in England is available from NHS England.
The Project
Support from our Pharmacy and Healthcare Services team to help member trust homecare teams in transitioning suitable patients to a biosimilar Ustekinumab product, included flagging the different options available to trusts and explaining how to use the Homecare Medicines Services framework agreement to access the biosimilar products now available.
In addition, on behalf of several members the Hub undertook the pre-preparation of relevant framework call-off documents, thus helping to minimise their local administrative burden.
As National Homecare Medicines Committee chair, Joe Bassett also worked closely with homecare providers to support expansion of innovative rapid switch models, and with NHSE Specialist Pharmacy Service (SPS) to provide concise and consistent advice relating to homecare aspects of this switch to trusts nationally.
The Outcome
The Hub’s efforts to assist trusts with a rapid switchover were challenged by stock shortages. The situation being caused by trusts seeking to maximise the savings opportunity from the MPSC open framework agreement while manufacturers attempt to increase supply into the country to meet demand.
In response we have been supporting member trusts to consider an alternative biosimilar product available through our Homecare Medicines Services framework.
If you would like similar support, please contact our Pharmacy and Healthcare Services team: [email protected].