In the wake of a sharp decline in sales of its blockbuster arthritis drug, Remicade, Merck & Co - known as MSD in the UK - is to offer the NHS discounts and rebates amounting to £48 million on £191 million sales, announced medical affairs director Colin Wheeler last week.

The move comes after approval by the National Institute for Health and Clinical Excellence (NICE) of both Remicade and biosimilar versions of infliximab and the launch of a resource to aid clinicians wishing to switch patients from Remicade to a biosimilar. 

Biosimilar infliximab was approved for use in Europe earlier this year and drugs launched so far include Pfizer subsidiary Hospira’s Inflectra and Napp Pharmaceutical’s Remsima, both manufactured by South Korean company Celltrion.

The discounts from MSD compare favourably with prices offered by Napp and Hospira, said Wheeler, adding that while biosimilar versions of Remicade currently have less than five percent market share in the UK and are mostly prescribed for newly diagnosed patients, the situation may change. 

The Norwegian government is funding a study to observe the effects of moving from Remicade to a biosimilar and is expected to publish results in the third quarter of 2016, announced Steinar Madsen, medical director at the Norwegian Medicines Agency recently.

Celltrion itself has already conducted a study showing that there were no differences in efficacy, adverse events and immunogenicity when patients with inflammatory bowel disease are switched to the company’s biosimilar from the original drug. 

74 patients in remission on long term treatment with Remicade were switched to Remsima. After a median follow up of 24 weeks, results from the study showed good efficacy for Remsima with the same maintenance of remission, minimal adverse events – including immunogenicity – and no difference in allergic reactions compared to the Remicade. The same trough levels of infliximab were seen in both drugs.

MSD sells Remicade in Europe under a license from Johnson & Johnson, which sells the drug in the US, where the patent is due to end in September 2018.