{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T19:20:45Z","timestamp":1791832845578,"version":"4.3.4"},"reference-count":37,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T00:00:00Z","timestamp":1778803200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T00:00:00Z","timestamp":1778803200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["ascpt.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin Pharma and Therapeutics"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:p>Biologic therapies are a major and growing driver of pharmaceutical expenditure globally, with tumor necrosis factor (TNF) inhibitors among the most widely used and costly biologics. In Australia, these therapies are funded through the Pharmaceutical Benefits Scheme (PBS), where biosimilars offer lower cost alternatives; however, the long\u2010term public expenditure impact of TNF inhibitor biosimilars under regulated pricing systems has not been comprehensively quantified. We conducted a retrospective, population\u2010level expenditure analysis using publicly available PBS Item Reports data from 2015 to 2025 to estimate PBS cost savings associated with the listing of adalimumab, etanercept, and infliximab biosimilars for inflammatory arthritis. Counterfactual scenarios were constructed to estimate expected expenditure in the absence of biosimilar entry, explicitly accounting for key PBS pricing mechanisms, including mandatory price reductions and price\u2010disclosure cycles. Biosimilar listing was associated with cumulative PBS savings of AU$562.3 million over the study period. Etanercept biosimilar generated the largest absolute savings (AU$341.5 million; 23.7% reduction), whereas adalimumab biosimilars generated smaller relative savings (AU$195.3 million; 9.4% reduction), reflecting delayed biosimilar entry despite high utilization. Most savings accrued in rheumatoid arthritis, followed by ankylosing spondylitis and psoriatic arthritis. In conclusion, TNF inhibitor biosimilars were associated with substantial and sustained reductions in public medicine expenditure in Australia. The magnitude of savings varied markedly by molecule and was jointly determined by the timing of biosimilar entry and statutory pricing mechanisms, illustrating how regulated reimbursement systems shape realized biosimilar value.<\/jats:p>","DOI":"10.1002\/cpt.70334","type":"journal-article","created":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T13:06:31Z","timestamp":1778850391000},"page":"684-691","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Ten\u2010Year Public Expenditure Savings Associated with\n                    <scp>TNF<\/scp>\n                    Inhibitor Biosimilars under Australia's Pharmaceutical Benefits Scheme"],"prefix":"10.1002","volume":"120","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7758-6087","authenticated-orcid":false,"given":"Chin Hang","family":"Yiu","sequence":"first","affiliation":[{"name":"The University of Sydney Sydney Pharmacy School  Camperdown New South Wales Australia"},{"name":"Kolling Institute, Faculty of Medicine and Health The University of Sydney and the Northern Sydney Local Health District  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-9771-3986","authenticated-orcid":false,"given":"Bella D.","family":"Ianni","sequence":"additional","affiliation":[{"name":"The University of Sydney Sydney Pharmacy School  Camperdown New South Wales Australia"},{"name":"Kolling Institute, Faculty of Medicine and Health The University of Sydney and the Northern Sydney Local Health District  Sydney New South Wales Australia"},{"name":"Department of Pharmacy Royal North Shore Hospital  St Leonards New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6045-6937","authenticated-orcid":false,"given":"Richard O.","family":"Day","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology &amp; Toxicology St Vincent's Hospital Sydney and St Vincent's Clinical Campus, UNSW Medicine  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3907-304X","authenticated-orcid":false,"given":"Jacques","family":"Raubenheimer","sequence":"additional","affiliation":[{"name":"The University of Sydney Sydney Pharmacy School  Camperdown New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7550-6837","authenticated-orcid":false,"given":"Christine Y.","family":"Lu","sequence":"additional","affiliation":[{"name":"The University of Sydney Sydney Pharmacy School  Camperdown New South Wales Australia"},{"name":"Kolling Institute, Faculty of Medicine and Health The University of Sydney and the Northern Sydney Local Health District  Sydney New South Wales Australia"},{"name":"Department of Pharmacy Royal North Shore Hospital  St Leonards New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,15]]},"reference":[{"key":"e_1_2_11_1_1","unstructured":"IQVIA Institute for Human Data Science.Global Medicine Spending and Usage Trends: Outlook to 2025<https:\/\/www.iqvia.com\/insights\/the\u2010iqvia\u2010institute\/reports\/global\u2010medicine\u2010spending\u2010and\u2010usage\u2010trends\u2010outlook\u2010to\u20102025>."},{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/nyas.15171"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajhp\/zxaf092"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrd2196"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.13103"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40265-017-0717-1"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.15872"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/14712598.2025.2512126"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11096-025-01956-6"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40290-025-00577-8"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/cpt.1836"},{"key":"e_1_2_11_12_1","unstructured":"MedicineWise N. 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