Before the deal NHS England spent more on Humira (adalimumab) than any other drug, and the deal, which also included a cut-price bid from AbbVie, represents the biggest saving in history from a single drug negotiation.

In a statement NHS England said the deal would pay for the equivalent of 11,700 more community nurses, or 19,800 breast cancer treatments.

Humira went off patent last month, allowing a group of companies to market cut-price biosimilars that were already approved by European regulators.

The deal should mean hospitals pay around a quarter of the more than £400 million each year they currently spend on adalimumab, which is used to treat severe hospital treated conditions such as rheumatoid arthritis, inflammatory bowel disease and psoriasis.

NHS England, working with NHS Improvement, is on course to deliver its ambition to cut £300 million from the nation’s annual medicines bill by 2021 through using best value biologic medicines a year early.

NHS England has accepted bids from four companies who manufacture biosimilar versions of the medicine – Amgen, Biogen, Mylan/Fujifilm Kyowa Kirin and Sandoz – as well as AbbVie.

Biosimilars are expected to become available to more than 46,000 patients with severe conditions such as rheumatoid arthritis, inflammatory bowel disease, and psoriasis, from December.

NHS England noted that it expected patients switching from Humira to a biosimilar to have the same response as with the original medicine.

Patients and doctors will be able to choose between alternative suppliers if one product is not appropriate.

In 2016/17 the NHS spent £18.2 billion on medicines, an increase of more than one third since 2010/11. In 2017/18, the NHS saved over £200 million by using best value biologics.

The government has just negotiated a five year voluntary pricing deal with the UK’s pharma trade body covering all four countries, although cost-effectiveness decisions are devolved.

The new Voluntary Scheme for Branded Medicines Pricing and Access has been agreed in principle with the Association of the British Pharmaceutical Industry (ABPI).

Under the new scheme there will be an annual 2% cap on the growth of branded medicines sales to the NHS, with any overspend repaid by pharma companies as a rebate based on net sales.

Further details need to be agreed, but the scheme is due to come into effect from 1 January 2019, replacing the old Pharmaceutical Price Regulation Scheme (PPRS).

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