ArticleThe European journal of health economics : HEPAC : health economics in prevention and care2024
The impact of an 'evergreening' strategy nearing patent expiration on the uptake of biosimilars and public healthcare costs: a case study on the introduction of a second administration form of trastuzumab in The Netherlands.
Article in The European journal of health economics : HEPAC : health economics in prevention and care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Biosimilars: A Virtuous Cycle of Sustainability and Innovation.BioDrugs : clinical immunotherapeutics, biopharmaceuticals and gene therapy · 2026Review
- Cost-Utility Analysis of Treatment Sequences for Moderate-to-Severe Crohn's Disease.PharmacoEconomics · 2025Article
- Barriers to adoption of biosimilar insulins in Europe: A mixed-methods study.Diabetes, obesity & metabolism · 2025Article
- Introduction of Biopharmaceuticals in Europe: A Cross-Sectional Study of Early Diffusion Patterns and Data Availability.BioDrugs : clinical immunotherapeutics, biopharmaceuticals and gene therapy · 2025Article
- Modelling the potential financial impacts of expanding access to immune checkpoint inhibitors as monotherapy for treating advanced non-small cell lung cancer.EClinicalMedicine · 2025Article
- Cost-Effective and Sustainable Drug Use in Hospitals: A Systematic and Practice-Based Approach.Applied health economics and health policy · 2025Article
- Fostering healthcare system sustainability through efficient practices: Can adopting biosimilars ease the financial burden of rheumatoid arthritis?F1000Research · 2024Review
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Authors and funding
5 authors.
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Abstract
In this paper, we explore dynamic market share and public healthcare costs of trastuzumab's evergreening (subcutaneous) variant during introduction of trastuzumab's competitive biosimilar variants in the Netherlands. We used a time series design to assess dynamic market share of trastuzumab's evergreening variant after introducing trastuzumab's biosimilar variants, focusing on the number of treatments and patients. The public healthcare costs of this evergreening strategy were estimated using administrative claims data. Our results show that the original trastuzumab was completely replaced by the subcutaneous and biosimilar variants. The uptake of the subcutaneous form peaked at 50% market share but after the introduction of biosimilars progressively reduced to a market share of 20%, resulting in a more competitive market structure. The public healthcare costs for trastuzumab significantly decreased after the introduction of the biosimilars. After the introduction of the biosimilars, a substantial price drop is visible, with the subcutaneous version, still under patent, also falling sharply in price but less strongly than the iv/biosimilar version. As the costs are publicly funded, we recommend a more explicit societal debate to consider if the potential benefits of subcutaneous Herceptin
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