Infliximab is a monoclonal antibody, anti-TNF alpha, used in the treatment of autoimmune diseases among which inflammatory bowel diseases such as ulcerative colitis and Crohn’s disease. Infliximab was the first biosimilar in the category of immunosuppressive drugs to enter the market (February 2015). All guidance documents agree to promote the use of biosimilar in naïve patients, while reserving the possibility of originator-biosimilar switches to the discretion of the clinician. This line has been shared and formalized by the Marche Region through the regional resolution 974/2014, which also emphasizes the role of pharmacists in promoting the use of biosimilars. This work aims to evaluate the prescribing trend of infliximab and the economic effects in the Gastroenterological Department. Through the Apoteca Manager software, all the infliximab doses requested by the Gastroenterology Department were analyzed in the period January 2016-December 2017. From the generated report, information such as type of drug, dosage and number of administrations were extrapolated. In 2016, 723 bags of infliximab were administrated, 476 (66%) of originator (1,748 units, € 851,410) and 247 (34%) of biosimilar (904 units, € 313,222). In 2017 the situation has completely reversed: of the 733 bags of infliximab administered, 496 (68%) contained the biosimilar and only 237 (32%) contained the originator, thus leading to an increase in the use of biosimilar of 100% with a decrease of the originator of 50%. The cost of an infliximab bag in the gastroenterological area in 2017 fell by € 239 and total savings amount to about € 159,000 (13.6%). The use of biosimilar infliximab is clearly a strategy that allows the containment of pharmaceutical spending and, at the same time, plays a crucial role as the savings generated allow to meet the growing health demand and can guarantee access to innovative therapies.

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Key words: infliximab, originator, biosimilar, naïve, switch, economical saving