Prospective Quality of Life and Economic Benefits From Increased Biosimilar Use in North America: A Targeted Literature Review

BACKGROUND Crohn’s disease (CD) reduces quality of life (QOL), which burdens society. Studies have identified clinical, psychological, and productivity determinants of QOL associated with CD, including increases in disease activity, relapse rate, mental illness, and workplace disability. Biologic treatments are effective and can improve patient QOL by reducing the disease severity, but high costs can limit access. Biosimilars provide similar efficacy and safety as reference products at a more cost-effective price, which can provide considerable savings. Biosimilars may generate societal benefits by allowing a greater number of patients to access similar treatment for the same cost compared to reference products. The objective of this study was to assess the current and expected savings from biosimilar use in North America (NA). METHODS A literature search was conducted using MEDLINE and grey literature from January 2020 to January 2025. Keywords included “projection*”, “economic”, “ex ante analysis”, “budget impact model”, and “biosimilar*”. Peer-reviewed publications and economic reports from industry, accredited associations, and state/provinces were included. RESULTS Twenty-seven peer-reviewed publications (18 from the US, 9 from Canada) and four reports were deemed relevant to the search question. Economic benefit was reported or forecasted by 94% (n = 30) studies. Across Medicare and US commercial plans, biosimilar use has been estimated to provide $12.4 billion in savings in 2023 alone. A projection report examining the US healthcare system estimated that cumulative use of over 20 biosimilars (including CD treatments such as infliximab, adalimumab, and ustekinumab) could yield savings of $125 to $237 billion from 2022 to 2027. Non-medical switching policies have been implemented in Canada to drive biosimilar uptake. The pilot adopter (British Columbia) reported $731 million in savings between 2019-2024 from use of eight biosimilars. While no NA studies were available, a study of cost-saving and patient access opportunities in Europe found €10.5 to €187 million in savings associated with biosimilar adalimumab uptake, which translates to an additional 1,096 to 19,454 patients able to access adalimumab for the same cost. Biosimilar introduction may create economic benefit through the direct reduction of treatment costs, as well as potential improvements in workplace function for patients without previous biologic access. CONCLUSION Increased access to effective CD treatment can improve patient QOL by reducing disease severity, psychological impact, and workplace disability. A growing body of literature demonstrates the potential economic benefits associated with the introduction or increased use of biosimilars for the US and Canada. Health economic decision makers should consider policies that favor biosimilar use as a tool to control costs.