The HEALTH : April 2020 | Page 15

APRIL, 2020 | THE HEALTH | Insight | Biosimilars a timely boost fo r kidney patients T HERE is a perception that the eff ectiveness or effi cacy of biosimilar products may not be as good as the originals. As such, having to choose between an original and a biosimilar can be a challenge for some doctors and patients. But according to Dato’ Dr Zaki Morad Mohamad Zaher, Consultant Nephrologist at KPJ Ampang Puteri Specialist Hospital, biosimilars can be as eff ective as the originals. A biosimilar is a ratifi ed product that is produced based on an original product approved by the US Food and Drug Administration (USFDA). It is formulated from a cell line from living organisms and is, therefore, not identical with the original product but has a similar and equal eff ect. A biosimilar product undergoes a series of rigorous tests before it can be registered. They include laboratory tests, animal studies and studies in humans. The latter includes a phase 1 study where it is used for the fi rst time in healthy human volunteers. A phase 2 human study investigates the use in a small number of patients with the condition for which the product is targeted. A phase 3 clinical trial is a larger trial where the biosimilar is compared against the original product in the target population for which it is indicated. Following satisfactory outcomes in all these studies, the product will be submitted for registration. Patients may ask if biosimilar products can be as efficient as the originals. That is why clinical trials are carried out for biosimilar products to prove the point on their effective-ness.” — Dato’ Dr Zaki Morad There are a few reasons for the existence of biosimilar products. “Firstly, it is due to the expiry of the patents for drugs. Original products can continue to be produced by the innovator company for a certain duration following which other companies have the right to develop similar ones. This opens up opportunities for products,” explained Dato’ Dr Zaki. Dato’ Dr Zaki said prescription of biosimilar products might raise concerns from patients on their effi cacy, cost and side eff ects. “Patients may ask if biosimilar products can be as effi cient as the originals. That is why clinical trials are carried out for biosimilar products to prove the point on their eff ectiveness. “Secondly, the concern would be the cost. Biosimilars are expected to be cheaper compared to the original product. If it costs more, people might as well revert to the original product,” said Dato’ Dr Zaki. As for side eff ects, he said that goes for any original product, not only biosimilars. A biosimilar which has the same expected outcome as the original, can be expected to have a similar side eff ects profi le Although most physicians would usually recommend original products, biosimilar products can benefi t the patients in terms of providing a cheaper option. Patients will have the alternative of paying less for a similar eff ect. “At present, we have one biosimilar product released in Malaysia. It is made from a certain cell line and produces an erythropoiesis-stimulating agents (ESA),” he said. An ESA is the synthetic form of a naturally produced hormone that stimulates the bone marrow to produce hemoglobin, the protein in our red cells that binds with oxygen and carries them to our tissues. The hormone is produced by the kidney and is defi cient in kidney failure patients. According to Dato’ Dr Zaki, there were three to four original products of this kind. The new biosimilar Erythropoietin has shown a similar improvement in Hemoglobin level and side eff ect profi le as the original. — The Health 15