The prices of adalimumab and etanercept fell differently in Finland and Estonia after biosimilars entered the market
Background Biosimilars are expected to bring cost savings with biological medicines. Reimbursement practices and prices differ between countries.
Methods We describe reimbursement practices and study price trends for adalimumab and etanercept in Finland and in Estonia before 2023. Based on the drug cost data in the Kelasto database, we evaluated how the costs of these drugs could have developed in Finland, if Finland had followed a similar process to that in Estonia.
Results In Finland, in order to be accepted into the reimbursement system, the wholesale price of the first biosimilar can be no more than 70 % of the wholesale price of the original product. After the initial cut, prices in Finland fell slowly and only for some of the products. Estonia used a reference price and a tendering process, and the prices fell faster than in Finland and for all the patients. If adalimumab and etanercept products in Finland had achieved an equally rapid price reduction in all cases, the cost savings in the years 2018–2021 would have been an estimated 183 million euros. The out of the pocket payments were lower in Estonia than in Finland.
Conclusions The previous practice has led to high prices for adalimumab and etanercept products in Finland. Finland is initiating reference pricing for biologicals,which may improve the situation.
Eneli Katunin, Kari Linden, Jarno Rutanen
