Abstract Background Treatment paradigms are shifting towards a ‘top down’ early adoption of biologic prescribing to achieve disease remission faster. However, these expensive treatments present a challenge to the financial sustainability of the NHS. Historically, adoption of biosimilar switching was slow due to a lack of dedicated resource, delaying NHS access to potential cost savings. A collaborative initiative between Pharmacy and Gastroenterology departments enabled the integration of an advanced pharmacist to lead biosimilar switching. Methods Pharmacist prescribing data was used to identify patients receiving ustekinumab. Each patient received a letter explaining the switch, along with an appointment for a face-to-face or virtual consultation with the pharmacist. The pharmacist conducted clinical assessments, including symptom review and disease activity scoring. Blood and calprotectin monitoring were performed around the switch in accordance with current practice. Results Switch period: November 2024 to June 2025 (8 months). Of 75 eligible patients (Figure 1), 70 were successfully switched, achieving a 93% switch-success rate and projected annual savings of £700,000. Three patients refused, one reverted to the original therapy, and one did not attend clinic. Conclusion The pharmacist achieved a 93% switch-success rate within eight months, resulting in projected annual savings of £700,000. Patients ‘on hold’ and ‘awaiting consultant review’ are opportunities for future switches. Combining written information with verbal consultation proved to be an effective approach for reassuring patients and addressing their questions and concerns. Added-value pharmacist contributions included: rigorous blood monitoring and clinical assessment including disease scoring; prudent prescribing with dose optimisation and timely switches to advanced therapies; holistic medication reviews with adherence checks; referrals to endoscopy and other specialties; stock management and supply optimisation; presentation of patients at MDT meetings; and provision of advice on vaccination, diet, NSAID avoidance, and medication storage. Overall, the pharmacist was able to deliver high quality patient-centred care alongside considerable cost savings to the healthcare economy. Conflict of interest: Mr. Jackson, David: Received sponsorship from AbbVie Inc. to attend ECCO Congress (Berlin, 19–22 Feb 2025) and BSG Congress (Glasgow, 23–26 Jun 2025). Evans, Stuart: No conflict of interest Clatworthy, Alan: No conflict of interest Nagari, Mithun: No conflict of interest.
Jackson et al. (Thu,) studied this question.
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