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Health systems across countries have used different policy measures (e.g. price discounts, tendering, mandating switches) to encourage the introduction of biosimilars but their differential impact on market penetration is unknown.

To evaluate the impact of policy measures on market penetration of anti-TNF biosimilars.

Quarterly IQVIA MIDAS sales data from 2012-2021 for infliximab, etanercept and adalimumab in 5 countries (Canada, France, Germany, Italy and the United Kingdom (UK)) that used different policy tools were used. Biosimilar market penetration was measured by dividing the number of defined daily dose units (DDDs) of biosimilars sold by the total number of DDDs of the originator and biosimilars sold. Market penetration since the first sale date of the biosimilars was captured by product, setting (hospital vs. retail), and country. Policy impact was examined by comparing …