Comparison of Utilization Trends between Biosimilars and Generics: Lessons from the Nationwide Claims Data in South Korea

  • Hye-Jae Lee
  • Euna HanEmail author
  • Hyero Kim
Original Research Article



South Korea is unique in that it leads global markets in R&D as well as production of biosimilar products and was the first market into which some biosimilar products were introduced. We analyzed the time trend of market penetration and simulated saved spending by biosimilars in South Korea.


We pulled Korean National Health Insurance claims data from January 2012–December 2018 for second-generation biologics, including infliximab, rituximab, and trastuzumab, and examined the time trends of expenditure, utilization in defined daily dose, and price. We also assessed market penetration by biosimilars and simulated expenditure savings gained due to their introduction. We comparatively examined time trends and spending savings during the same period for selected small-molecule generic drugs to understand any specifics limited to biosimilars for time trends of market share and quantity-standardized prices.


The market share for infliximab biosimilar plateaued at over 30%, which is smaller than the market penetration of esomeprazole (over 60%), a small-molecule comparator. Despite a shorter observation period, rituximab and trastuzumab biosimilars also showed larger utilization rates (12.89% and 13.93%, respectively) than infliximab (9.05%) in their second year after market entry. Infliximab was associated with approximately US $82–114 million expenditure savings over 6 years after its biosimilar entry to the market. Rituximab and trastuzumab biosimilars each also resulted in reduction in total spending by approximately US $9–14 million, in less than 2 years.


Biosimilars captured the market rapidly, despite a heterogeneous uptake rate by product in South Korea. However, expansion of biosimilar use in the market and consequent expenditure savings need to be supported by pre-emptive policy measures to encourage price competition and boost utilization.


Author contributions

EH and HJL conceived the study. HJL performed data cleaning and analyses and EH verified the analytical methods. HK performed the literature review. EH and HJL drafted the manuscript. All authors discussed the results and commented on the manuscript.

Compliance with Ethical Standards

Conflict of interest

Research support from the Korea National Research Foundation [Grant number 2019R1A2C1003259] is gratefully acknowledged. The content is solely the responsibility of the authors and does not necessarily represent the official view of the Korea National Research Foundation. The Korea National Research Foundation had no involvement in preparation and submission of this manuscript. The authors declare that they have no competing interests.


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.National Health Insurance Research Institute, National Health Insurance ServiceWonjuSouth Korea
  2. 2.College of PharmacyWoosuk UniversityWanju-gunSouth Korea
  3. 3.College of Pharmacy, Yonsei Institute for Pharmaceutical ResearchYonsei UniversityIncheonSouth Korea

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