This article evaluates an incentive for hospital prescriptions of biosimilars delivered in retail pharmacies, whereby gains are shared between hospitals and the French NHI and incentives are directly redirected to prescribing units. Using SNDS data, we compare the pre- and post- biosimilar prescription rates of treated public hospitals with those observed at similar facilities. Between October 2018 and September 2021, the pilot led to an increase in biosimilar use for insulin glargine (+6.0 percentage points) and etanercept (+10.8 ppt). The pilot generated 0.5% cost savings for insulin glargine and 0.1% for etanercept. Cost savings for the French NHI are modest even though the incentive dramatically boosted biosimilar use. The fact that medication price changes outpaced the rate at which incentives are adjusted is the primary reason for this, in addition to deadweight loss effects.

Citation: Attia, V., Gaini, M., Maugendre, E. & Pollak, C. (2024). Biosimilar Prescribing Incentives: Results of a French Pilot of Gainsharing Between Hospitals and the National Health Insurance. Economie et Statistique / Economics and Statistics, 542, 147–168. doi: 10.24187/ecostat.2024.542.2115