Date: 04 February 2019
A local patient being treated for inflammatory bowel disease (IBD) has shared his experience of switching to a biosimilar, a type of medicine developed to be highly similar and clinically equivalent to the existing biological drug used for his treatment.
Lee Robinson, from Southampton, was diagnosed with IBD over thirty years ago. Affecting more than 300,000 people in the UK, IBD is a term typically used to describe ulcerative colitis or Crohn’s disease, two long-term conditions which involve inflammation of the gut. Current treatment options take a number of forms, from changes in diet and lifestyle to medicines or surgery. There’s currently no cure available for IBD but treatment aims to relieve symptoms and improve quality of life.
Lee’s treatment involved regular infusions of infliximab, a medicine that works by targeting the protein in the body which is thought to be partly responsible for the ongoing inflammation experienced by patients with IBD. Infliximab is an example of a biological drug, made from naturally occurring substances rather than a chemical process. Over the years, biological medicines like infliximab have revolutionised the treatment of many serious and chronic illnesses such as IBD, however they are expensive to develop and manufacture making them costly for the NHS to provide to patients.
When the patent protection for Remicade (the brand name for the original version of infliximab) was about to expire, Lee’s Consultant Gastroenterologist Dr Fraser Cummings pioneered a biosimilar switching programme at University Hospital Southampton NHS Foundation Trust. Backed by research and with agreement from Southampton’s IBD patient panel, the programme involved switching patients like Lee from the originator biological drug to a biosimilar.
Lee, who is also the chair of the Southampton IBD patient panel, explains what it was like to be part of the switching programme:
“When I was taking Remicade I felt absolutely fantastic. It was the best I’d felt in years. So when Remicade was coming to the end of its patent, Dr Cummings had done his own research and he’d found a similar.
“When the biosimilar conversation first started taking place, I was hoping and praying the IBD patient panel were all going to say no because as an individual I felt fantastic on Remicade. But it was a panel decision and as a panel we decided that we would go with the biosimilar switch, with the understanding that if it didn’t work, there would always be the option to go back to Remicade. The switch to biosimilars was never ever set in stone and I think that was key to going forward with it.
“When I made the switch, the downside for me was that my infusion times were back up to two hours when they had been down to half an hour because I was established on Remicade. It was a massive difference but the plus side was that there was no change in how I was and I still felt great.”
With the uptake of biosimilars accelerating across the NHS and the evidence base for their use growing, more research into biosimilars will continue to be key. Lee adds:
“Research is massive. When we meet as a patient panel, something new is always coming onto the market with the help of the patients who volunteer in research. Hopefully one day they’ll find a cure for IBD, but if they don’t they’re as near as they can be and that’s all down to research.
“As a patient, I feel better now than I’ve ever done. Having a clinical nursing team has made that difference because they’re responsible for your wellbeing, they understand the drugs and they can look at you as an individual rather than a unit. When I go into clinic, I do feel as though I’m Lee, I’m not just a patient.
“Thirty years ago, I don’t believe the word Crohn’s was invented like it is today. I don’t think people really knew what it was back then. When I first got diagnosed, people hadn’t heard of it unless they were actually in that field. Whereas now, if I go to A & E and tell them I’ve got Crohn’s they know what that is and that’s down to research, it’s down to medicine, it’s down to people caring.”
With the promise of a smaller price tag, biosimilar medicines continue to play a major role in ensuring the sustainability of the NHS. Broadening access to cutting edge treatments, they bring new hope to patients who do not currently meet the current prescribing thresholds for biological drugs. The NIHR has developed a campaign to explore some of the potential benefits of biosimilar medicines, including why NHS health professionals should support clinical trials of biosimilar drugs and why patients should consider taking part in a switching programme.
Find out more by visiting: https://www.nihr.ac.uk/news-and-events/support-our-campaigns/biosimilars/
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