Biosimilar uptake could unlock major savings for European healthcare systems
Greater uptake of biosimilar medicines could deliver substantial savings for European health systems, but will require coordinated policies on procurement, prescribing and dispensing.
European health systems could unlock substantial savings by increasing the use of biosimilar medicines, but doing so will require a coordinated mix of procurement, prescribing and dispensing policies, according to a policy brief from the European Observatory on Health Systems and Policies.
The potential savings are significant. Research cited in the brief estimated that Spain saved €2.3 billion between 2009 and 2019 by adopting biosimilar medicines. Three substances (infliximab, somatropin and epoetin) accounted for 60% of the savings, while in 2019 alone biosimilars generated savings equivalent to 3.92% of Spain’s total pharmaceutical expenditure.
Biosimilars are highly similar versions of biological originator medicines, like generics they are off patent and are therefore much cheaper. Europe has led in their approval. As of June 2025, the European Medicines Agency had approved 126 biosimilar medicines for use, compared to 75 approved in the United States.
Yet uptake of biosimilars varies substantially between European countries, regions and individual hospitals, suggesting health systems are not uniformly capturing the potential savings.
Drawing on policies in 30 European countries, the study says successful implementation “does not rely on a single action” but requires supply- and demand-side measures working together.
On the supply side, the report outlines several proposals, including centralized tendering at hospital level and more action to address anti-competitive behaviour. Where countries have reference price systems, they could align biological substances or therapeutic class, making cost savings and interchangeability clearer.
On the demand side, the study recommends prescriber guidance among other measures: “Switching patients from an originator to a biosimilar medicine is obligatory in some countries and encouraged in others.” Prescribing quotas and gain-sharing schemes, under which healthcare providers can benefit from some of the savings generated, have also been associated with increased biosimilar prescribing.
The study sees greater scope for pharmacists to play a role. Biosimilar substitution in community pharmacies remains less common than generic substitution.
With biosimilars already well established in Europe, the brief suggests the challenge is now translating their availability into wider use.