{
  "abstract": "Context With the expiration of patents on several high-cost biologics, the NHS has prioritised the integration of biosimilars to reduce pharmaceutical expenditure and improve access to treatment. Biosimilars offer equivalent safety and efficacy to originator products at a lower cost, enabling substantial savings that can be reinvested into broader patient care. This project outlines the strategy and outcomes of transitioning rheumatology patients from branded biologics to biosimilars within a paediatric hospital setting safely and effectively.Strategy for Change A multidisciplinary approach was adopted to switch patients from Humira® to Amgevita® (adalimumab) and from Enbrel® to Benepali® (etanercept).Key actions included – Prescriber engagement through education on biosimilar equivalence and departmental agreement to proceed with the transition.– Patient–centred counselling to address concerns and support informed decision–making.– Pharmacy leadership, with a dedicated Pharmacy Technician coordinating the switch, supporting patient education with the specialist nursing team.Prescribing practices were communicated across the specialist team to recommend biosimilars as first-line options, ensuring consistency across the department.During routine rheumatology clinics, patients were identified for the transition to biosimilars. Once consented, the homecare provider was notified to initiate the biosimilar. Patients newly initiated on biologic therapy commenced directly onto the biosimilar where appropriate. Pharmacy ensured product availability for in-clinic administration and managed stock to support seamless transitions to homecare delivery.Robust monitoring underpinned the implementation Clinical outcomes, patient uptake, and financial savings were systematically tracked. Patients who did not tolerate biosimilars were reverted to originator products, with outcomes documented. Misconceptions—particularly among patients stable on branded therapies—were addressed through personalised, one-to-one engagement.Results Ten patients were switched to biosimilar etanercept, and nil reverted to the originator.A total of 75 patients were on adalimumab and reviewed for the project:– 52 patients switched to Amjevita and maintained on therapy– 10 patients stopped treatment due to therapy change or intended cessation– 2 patients refused to switch– 1 patient was discharged to a different hospital– 8 patients were transitioned to adult care therefore not switched to biosimilar– 2 patients reverted to originatorReasons for reversion:– Lack of clinical response to the biosimilar– Difficulties using the pen deviceProjected annual savings:– Amgevita®: £86,000– Benepali®: £34,000Conclusion Several challenges emerged during implementation:– Prescriber hesitancy required comprehensive education on biosimilar safety and efficacy.– Patient anxiety about switching from trusted therapies necessitated personalised reassurance.– Logistical complexities in coordinating communication across departments and providers required careful planning to avoid delays or errors.– A small subset of patients required reversion to originator products, highlighting the need for ongoing clinical flexibility.Despite these challenges, the transition was successful. The majority of patients switched without compromise to clinical outcomes, leading to measurable NHS cost savings and improved consistency in prescribing.This initiative demonstrates that with structured planning, cross-disciplinary collaboration, and proactive patient engagement, biosimilar integration can deliver both clinical safety and economic value. Building on this success, we plan to use this model as a foundation for other biologic therapies and to share with other specialties in the Trust for biologic transitions.\\",
  "authors": [
    {
      "affiliations": [
        "Birmingham Women’s and Children’s Hospital NHS Foundation Trust, UK"
      ],
      "name": "Amrita Garcha"
    },
    {
      "affiliations": [
        "Birmingham Women’s and Children’s Hospital NHS Foundation Trust, UK"
      ],
      "name": "Maya Harper"
    }
  ],
  "title": "P14 Quality improvement in rheumatology: transitioning to biosimilars",
  "uid": "495cf8e6-061c-59c1-888b-5190453cd3ae"
}