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xi
Introduction by Professor
Francisco Baralle
I am pleased to see the second edition of the epic book on biosimilars authored by Professor Sarfaraz
K. Niazi, wherein I have introduced him and his work. At the time of writing this book, I was
heading the International Centre for Genetic Engineering and Biotechnology (ICGEB), a unique
intergovernmental organization initially established as a particular project of UNIDO. The ICGEB
has been an autonomous organization since 1994, and it has run over 45 state- of- the- art laboratories
in Trieste (Italy), New Delhi (India), and Cape Town (South Africa). It is an interactive network with
almost 70 Member States, with operations aligned to those of the United Nations System. It plays a
crucial role in biotechnology, especially in promoting research excellence, training, and technology
transfer to industry to achieve a concrete contribution to sustainable global development. I became
acquainted with Professor Niazi when he began his career in biotechnology in the early 1990s. I am
pleased that the ICGEB was able to fulll many needs of a recombinant startup manufacturing globally, in several instances, in collaboration with Professor Niazi.
In my 2006 introduction to his excellent book, Handbook of Biogeneric Therapeutic
Proteins: Regulatory, Manufacturing, Testing, and Patent Issues, I called it a signicant milestone in furthering biotechnology applications, and in this case, the milestone is manufacturing
of recombinant therapeutic proteins, worldwide. Now that Professor Niazi has fullled his ambition of securing the registration of biosimilars globally, he has revised his book to add decades of
experience that has made this book a practical handbook for startups and established companies. In
addition, this handbook will be helpful for anyone involved in the development, regulatory ling,
and manufacturing of biosimilars, especially with regard to the term he has proposed in his book.
He soon discovered that the term “generic” has legal constraints; hence, the best term would be
“biosimilars.” This term is almost a universal representation of the copies of biological drugs that
have “no clinically meaningful difference” with their reference products.
One of the most signicant breakthroughs in the eld of biotechnology was achieved in the third
quarter of the past century when scientists could clone the gene and combine it with the host DNA
to produce the desired target molecules; thus, recombinant technology evolved. Insulin was the
rst endogenous hormone that was produced through recombinant technology and that beneted
millions of patients worldwide. Indeed, today, the only major source of insulin is synthesis through
recombinant technology in Escherichia coli cells. However, the recombinant techniques became
useful only after the US Supreme Court ruling that a recombinant bacterium or a life form can
be patented; since then, hundreds of endogenous molecules have been produced by recombinant
techniques to bring a solution to humanity for diseases that were once thought of as incurable.
Indeed, mortality from diseases related to the deciency of endogenous proteins in patients has
signicantly decreased; yet, these drugs are very expensive, mainly because of the high investment
required to develop and manufacture drugs. Delays also occur in the introduction of biosimilars
owing to intellectual property constraints. Professor Niazi is also a patent law practitioner in the US,
and he has described many strategies for managing IP risks effectively in this book.
The teachings in this book should go a long way in helping generic companies worldwide establish
more efcient manufacturing systems while delivering a comparable quality product at a fraction of
the price of the current innovator products. This can lead to a better quality of life and, therefore, an
overall reduction in healthcare costs worldwide, which is one of the most serious concerning issues
of global healthcare organizations such as the United Nations and the World Health Organization.
The Handbook of Biogeneric Therapeutic Proteins was the rst comprehensive treatise on
every aspect of manufacturing recombinant drugs; it was remarkable how such a large volume of
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xii
Introduction by Professor Baralle
information has been condensed into only a few hundred pages. After almost two decades, information, knowledge, and perspectives in the development and manufacturing of recombinant drugs have
changed drastically; the second edition involves a change in the title from “generic” to “similar”
but maintains the proven convenient and informative structure. This is a handbook, not a textbook;
therefore, the emphasis remains on practical applications rather than the theories underlying the
processes and methods. However, it is inevitable not to discuss some theory when describing these
details. The book provides just the right balance between science and practical applications.
It was a pleasure to review this book authored by Professor Niazi, who has an eloquent style of
expression and the ability to condense a large volume of data into a lucid format. I hope that more
people will benet from the emerging eld of biotechnology through this book and from the experience of Dr. Niazi in this eld. I particularly hope that developers in the developing world, which is
the primary focus at ICGEB and, in particular, its Biotechnology Unit, will benet from the timely,
up- to- date information provided in this book to develop products that are now off- patent and make
these products available to the public at a price they can afford while maintaining quality standards.
Furthermore, I hope that prospective manufacturers will gain extensively from the discussion of
quality systems in the book and, accordingly, build facilities of the highest standards; this is the only
way to ensure the safety of biological products.
Professor Francisco Baralle
Trieste, Italy
baralle@fegato.it
Professor Francisco Baralle is the president of the
Scientic Committee, IRNA Metabolism Group, Italian
Liver Foundation, Trieste, Italy. He was the second director
general of the International Centre for Genetic Engineering
and Biotechnology (ICGEB) in Trieste, Italy, since the
institute’s inception under a charter of the United Nations in
1984. Professor Baralle has motivated hundreds of scientists
worldwide to develop applications of biotechnology to
resolve the endogenous problems of developing countries.
He has made substantial contributions to the science of
molecular biology, proteomics, and recombinant techniques.
A former professor of pathology at the University of Oxford,
member of Magdalen College, and elected member of the
Molecular European Biology Organization, Professor
Baralle has pioneered cloning techniques and developed
several new biological drugs. Under his supervision, the
ICGEB developed programs for extensive training in
constructing genetically modied cells and has offered global assistance in recombinant therapeutic
protein manufacturing.

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Overview of the
1
Development of Biosimilar
Biopharmaceuticals
1.1 INTRODUCTION
The cost involved in the development of a new drug has currently reached billions of United States
dollars (USD), and the price has remained high for at least 5 years for a new chemical and 12 years
for a new biological drug. Additionally, the stringent regulatory guidelines have increased the cost
involved in the approval of a new biological drug to hundreds of million USD, resulting in the high
price of these products (Table 1.1) to amortize the investment over 12 years of exclusivity for biological drugs.
As patents expire at the time of approval of a new drug, its biosimilars enter the market, a history that is not only remarkable in its lifetime but also shaky in terms of the extent to which the
biosimilars have entered the market. A severe deciency in the biosimilar landscape is the dearth
of molecules entering the market; thus far, only 14 molecules are available in the US and 14 in the
European Union, while many remarkable choices await entry (Tables 1.2– 1.4).
The rst tranche of biosimilar approval guidelines raised an abundance of caution for biosimilars
(e.g., new biological drugs), especially through extensive analytical comparisons, animal pharmacology and toxicology, clinical pharmacology, and clinical safety and efcacy studies. The only
exception from those studies was the extrapolation of the indications. A comparative clinical efcacy testing in one indication would be sufcient to qualify all other indications allowed for the reference product. To further assure safety and efcacy, biosimilars must be used with the same dose,
strength, route of administration, and mechanism of action (MOA); however, the formulations may
differ. Additionally, the prescribing information must be the same; guidelines for writing the prescribing information for biosimilars are available.
Over time, the agencies became more convinced of the safety of biosimilars in response to
challenges against the guidelines. It became well accepted that animal testing of biosimilars is
redundant; since recently, even new biological products may not require such testing because the
MOA of biological drugs involves receptor binding that is often unavailable in animal species. The
signicance of clinical efcacy testing has also been criticized for scientic reasons because such
studies cannot demonstrate negative results; if the studies aim to overcome the lack of similarity
in the analytical or clinical pharmacology proles, then it leads to a higher possibility for safety
risk when such studies are considered for biosimilar approval. An excellent example of progressive changes to guidelines is the Medicines and Healthcare products Regulatory Agency of UK
(MHRA). Last year, as the Brexit transition period ended, the MHRA published its rst comprehensive guideline on May 14, 2022, and it deviated from all other guidelines by providing a clear
rationale for not requiring animal and clinical efcacy testing.
Clinical pharmacology studies, including those comparing pharmacokinetics (PK) and pharmacodynamics (PD), are part of the analytical methodology, wherein similarities can be established
DOI: 10.1201/9781003392026-1
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TABLE 1.1
Biosimilar Biopharmaceuticals
Most Expensive Treatment Costs
Drug Active Indication Cost, USD
Actemra Tocilizumab Rheumatoid arthritis and cytokine
release syndrome
Acthar Gel Repository
corticotropin
Multiple sclerosis, infantile spasms, and
nephrotic syndrome
Actimmune Interferon gamma- 1b Chronic granulomatous disease and
severe, malignant osteopetrosis
Alecensa Alectinib Non– small cell lung cancer 159,000– 178,000/ yr
Almita Olorinab Breast cancer 150,000/ yr
Amondys 45 Casimersen Duchenne muscular dystrophy 300,000/ yr
Blenrep Belantamab
Multiple myeloma 400,000/ yr
mafodotin
Blincyto Blinatumomab Acute lymphoblastic leukemia 178,000/ trt
Braftovi Encorafenib Melanoma 174,000/ yr
Brineura Cerliponase alfa Late infantile neuronal ceroid
lipofuscinosis type 2 (CLN2)
Bylvay Lumasiran Bile acid synthesis disorders 300,000/ yr
Calquence Acalabrutinib Chronic lymphocytic leukemia 175,000/ yr
Ceredase Alglucerase Gaucher disease 200,000– 300,000/ yr
Cerezyme Imiglucerase Gaucher disease 350,000/ yr
Darzalex Daratumumab Multiple myeloma 150,000– 170,000/ yr
Elaprase Idursulfase Hunter syndrome (MPS II) 375,000/ yr
Erwinaze Asparaginase Erwinia
Acute lymphoblastic leukemia 14,000– 28,000 per vial
chrysanthemi
Evrysdi Risdiplam Spinal muscular atrophy 340,000/ yr
Firdapse Amifampridine Lambert– Eaton myasthenic syndrome 140,000/ yr
Gattex Teduglutide Short bowel syndrome 350,000– 400,000/ yr
Gilenya Fingolimod Multiple sclerosis 90,000– 100,000/ yr
Glybera Alipogene tiparvovec Lipoprotein lipase deciency 1,000,000/ trt
Harvoni Ledipasvir +
Chronic hepatitis C 94,500/ trt
sofosbuvir
Hemlibra Emicizumab Prevention of bleeding episodes in
hemophilia A with factor VIII
inhibitors
Ilaris Canakinumab Cryopyrin- associated periodic
syndromes (CAPS) and systemic
juvenile idiopathic arthritis
Imnzi Durvalumab Certain types of cancer including lung
cancer
Isturisa Osilodrostat Cushing’s disease 295,000/ yr
Jaka Ruxolitinib Myelobrosis and polycythemia vera 12,000– 14,000/ month
Kalydeco Ivacaftor Cystic brosis 330,000– 360,000/ yr
Keytruda Pembrolizumab Various types of cancer, including
melanoma and lung cancer
Kymriah Tisagenlecleucel Certain types of non- Hodgkin lymphoma
and acute lymphoblastic leukemia
Kyprolis Carlzomib Multiple myeloma 180,000– 200,000/ yr
Lumakras Sotorasib Non– small cell lung cancer 17,000/ month
Luxturna Voretigene neparvovec Inherited retinal diseases causing
blindness
Mavenclad Cladribine Multiple sclerosis 99,000/ yr
6,000– 9,000/ month
40,000– 60,000 per vial
157,000/ yr
350,000/ yr
482,000/ yr
200,000– 300,000/ yr
150,000– 170,000/ yr
150,000– 170,000/ yr
475,000/ trt
850,000/ trt

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Biosimilar Biopharmaceuticals
TABLE 1.1 (Continued)
Most Expensive Treatment Costs
Drug Active Indication Cost, USD
Monjuvi Tafasitamab Diffuse large B- cell lymphoma 160,000/ yr
Myalept Metreleptin Leptin deciency in generalized
lipodystrophy
Naglazyme Galsulfase Mucopolysaccharidosis VI (MPS VI) 375,000/ yr
Nerlynx Neratinib Breast cancer 150,000/ yr
Ocrevus Ocrelizumab Multiple sclerosis 65,000/ yr
Olysio Simeprevir Chronic hepatitis C 66,000– 84,000/ trt
Opdivo Nivolumab Various types of cancer, including
melanoma and lung cancer
Opdivo plus Nivolumab +
Ipilimumab
Opsumit Macitentan Pulmonary arterial hypertension 200,000– 220,000/ yr
Orfadin Nitisinone Hereditary tyrosinemia type 1 275,000/ yr
Orkambi Lumacaftor + Ivacaftor Cystic brosis 260,000– 300,000/ yr
Orladeyo Berotralstat Hereditary angioedema 470,000/ yr
Orlissa Elagolix Endometriosis and uterine broids 30,000/ yr
Padcev Enfortumab vedotin Urothelial cancer 16,000/ month
Pomalyst Pomalidomide Multiple myeloma 160,000– 180,000/ yr
Pulmozyme Dornase alfa Cystic brosis 311,000/ yr
Ravicti Glycerol
phenylbutyrate
Remicade Iniximab Rheumatoid arthritis, Crohn’s disease,
Rozlytrek Entrectinib Solid tumors with NTRK gene fusion 450,000/ yr
Sandostatin LAR Octreotide Acromegaly and neuroendocrine tumors 15,000– 20,000/ month
Signifor Pasireotide Cushing’s disease and acromegaly 200,000– 300,000/ yr
Soliris Eculizumab Paroxysmal nocturnal hemoglobinuria
Sovaldi Sofosbuvir Chronic hepatitis C 84,000/ trt
Spinraza Nusinersen Spinal muscular atrophy 375,000 for the rst year and
Sprycel Dasatinib Chronic myeloid leukemia and acute
Stelara Ustekinumab Psoriasis, psoriatic arthritis, and
Strensiq Asfotase alfa Hypophosphatasia 300,000/ yr
Synagis Palivizumab Prevention of respiratory syncytial
Takhzyro Lanadelumab Hereditary angioedema 488,000/ yr
Tecentriq Atezolizumab Certain types of cancer, including
Translarna Ataluren Duchenne muscular dystrophy 262,000/ yr
Trikafta Elexacaftor +
tezacaftor +
ivacaftor
Ultomiris Ravulizumab Paroxysmal nocturnal hemoglobinuria
Certain types of cancer, including
melanoma and lung cancer
Chronic management of urea cycle
disorders
and other autoimmune conditions
and atypical hemolytic uremic
syndrome
lymphoblastic leukemia
Crohn’s disease
virus (RSV) in infants
bladder cancer
Cystic brosis 311,000/ yr
and atypical hemolytic uremic
syndrome
700,000/ yr
150,000– 170,000/ yr
250,000– 270,000/ yr
350,000– 400,000/ yr
30,000– 40,000/ yr
500,000– 700,000/ yr
375,000/ yr after that
120,000– 130,000/ yr
30,000– 40,000/ yr
9,000– 15,000/ month during
the RSV season
150,000– 170,000/ yr
498,000/ yr
(continued)
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Biosimilar Biopharmaceuticals
TABLE 1.1 (Continued)
Most Expensive Treatment Costs
Drug Active Indication Cost, USD
Vimizim Elosulfase alfa Morquio A syndrome 375,000/ yr
Vitrakvi Larotrectinib Solid tumors with NTRK gene fusion 400,000/ yr
Xalkori Crizotinib Small- cell lung cancer 149,000– 167,000/ yr
Xolair Omalizumab Severe asthma and chronic idiopathic
urticarial
Xpovio Selinexor Multiple myeloma 160,000/ yr
Xtandi Enzalutamide Prostate cancer 129,000– 144,000/ yr
Xyrem Sodium oxybate Narcolepsy with cataplexy 50,000– 75,000/ yr
Yervoy Ipilimumab Certain types of cancer, including
melanoma
Yescarta Axicabtagene
Certain types of non- Hodgkin lymphoma 373,000/ trt
ciloleucel
Zolgensma Onasemnogene
Spinal muscular atrophy 2,100,000/ trt
abeparvovec
Hemgenix Viral gene therapy Hemophilia B gene 43,000,000 per dose
Note: Therapeutic proteins are shown in bold.
32,500/ yr
150,000– 170,000/ yr
TABLE 1.2
Forty- One FDA Approvals of Biosimilars
No. Biosimilar Name Approval Date Reference Product
1. Tyruko (natalizumab- stn) August 2023 Tysabri (natalizumab)
2. Yuyma (adalimumab- aaty) May 2023 Humira (adalimumab)
3. Idacio (adalimumab- aacf) December 2022 Humira (adalimumab)
4. Vegzelma (bevacizumab- adcd) September 2022 Avastin (bevacizumab)
5. Stimufend (peglgrastim- fpgk) September 2022 Neulasta (peglgrastim)
6. Cimerli (ranibizumab- eqrn) August 2022 Lucentis (ranibizumab)
7. Fylnetra (peglgrastim- pbbk) May 2022 Neulasta (peglgrastim)
8. Alymsys (bevacizumab- maly) April 2022 Avastin (bevacizumab)
9. Releuko (lgrastim- ayow) February 2022 Neupogen (lgrastim)
10. Yusimry (adalimumab- aqvh) December 2021 Humira (adalimumab)
11. Rezvoglar (insulin glargine- aglr) December 2021 Lantus (insulin glargine)
12. Byooviz (ranibizumab- nuna) September 2021 Lucentis (ranibizumab)
13. Semglee (Insulin glargine- yfgn) July 2021 Lantus (Insulin glargine)
14. Riabni (rituximab- arrx) December 2020 Rituxan (rituximab)
15. Hulio (adalimumab- fkjp) July 2020 Humira (adalimumab)
16. Nyvepria (peglgrastim- apgf) June 2020 Neulasta (peglgrastim)
17. Avsola (iniximab- axxq) December 2019 Remicade (iniximab)
18. Abrilada (adalimumab- afzb) November 2019 Humira (adalimumab)
19. Ziextenzo (peglgrastim- bmez) November 2019 Neulasta (peglgrastim)
20. Hadlima (adalimumab- bwwd) July 2019 Humira (adalimumab)
21. Ruxience (rituximab- pvvr) July 2019 Rituxan (rituximab)
22. Zirabev (bevacizumab- bvzr) June 2019 Avastin (bevacizumab)
23. Kanjinti (trastuzumab- anns) June 2019 Herceptin (trastuzumab)
24. Eticovo (etanercept- ykro) April 2019 Enbrel (etanercept)
25. Trazimera (trastuzumab- qyyp) March 2019 Herceptin (trastuzumab)

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Biosimilar Biopharmaceuticals
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TABLE 1.2 (Continued)
Forty- One FDA Approvals of Biosimilars
No. Biosimilar Name Approval Date Reference Product
26. Ontruzant (trastuzumab- dttb) January 2019 Herceptin (trastuzumab)
27. Herzuma (trastuzumab- pkrb) December 2018 Herceptin (trastuzumab)
28. Truxima (rituximab- abbs) November 2018 Rituxan (rituximab)
29. Udenyca (peglgrastim- cbqv) November 2018 Neulasta (peglgrastim)
30. Hyrimoz (adalimumab- adaz) October 2018 Humira (adalimumab)
31. Nivestym (lgrastim- aa) July 2018 Neupogen (lgrastim)
32. Fulphila (peglgrastim- jmdb) June 2018 Neluasta (peglgrastim)
33. Retacrit (epoetin alfa- epbx) May 2018 Epogen (epoetin- alfa)
34. Ixi (iniximab- qbtx) December 2017 Remicade (iniximab)
35. Ogivri (trastuzumab- dkst) December 2017 Herceptin (trastuzumab)
36. Mvasi (Bevacizumab- awwb) September 2017 Avastin (bevacizumab)
37. Cyltezo (Adalimumab- adbm) August 2017 Humira (adalimumab)
38. Renexis (Iniximab- abda) May 2017 Remicade (iniximab)
39. Amjevita (Adalimumab– atto) September 2016 Humira (adalimumab)
40. Erelzi (Etanercept- szzs) August 2016 Enbrel (etanercept)
41. Inectra (Iniximab- dyyb) April 2016 Remicade (iniximab)
42. Zarxio (Filgrastim- sndz) March 2015 Neupogen (lgrastim)
Note: There were no reported rejections or withdrawals (www.fda.gov/ drugs/ bios imil ars/ bio simi lar- prod uct- info rmat ion).
TABLE 1.3
Biosimilars Approved, Rejected, and Withdrawn in the European Union
No. Product Name Active Substance Authorization Date
1. Vegzelma Bevacizumab March 22, 2023
2. Sondelbay Teriparatide June 16, 2022
3. Stimufend Peglgrastim March 12, 2022
4. Hukyndra Adalimumab November 15, 2021
5. Libmyris Adalimumab November 12, 2021
6. Byooviz Ranibizumab August 18, 2021
7. Abevmy Bevacizumab April 21, 2021
8. Alymsys Bevacizumab March 26, 2021
9. Oyavas Bevacizumab March 26, 2021
10. Yuyma Adalimumab February 11, 2021
11. Kirsty (previously
Kixelle)
12. Onbevzi Bevacizumab January 11, 2021
13. Nyvepria Peglgrastim November 18, 2020
14. Livogiva Teriparatide August 27, 2020
15. Aybintio Bevacizumab August 19, 2020
16. Zercepac Trastuzumab July 27, 2020
17. Insulin aspart Sano Insulin aspart June 25, 2020
18. Nepexto Etanercept May 25, 2020
19. Ruxience Rituximab April 1, 2020
20. Amsparity Adalimumab February 13, 2020
Insulin aspart February 5, 2021
(continued)

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Biosimilar Biopharmaceuticals
TABLE 1.3 (Continued)
Biosimilars Approved, Rejected, and Withdrawn in the European Union
No. Product Name Active Substance Authorization Date
21. Cegla Peglgrastim December 19, 2019
22. Grasustek Peglgrastim June 20, 2019
23. Idacio Adalimumab April 2, 2019
24. Zirabev Bevacizumab February 14, 2019
25. Ogivri Trastuzumab December 12, 2018
26. Ziextenzo Peglgrastim November 22, 2018
27. Fulphila Peglgrastim November 20, 2018
28. Pelmeg Peglgrastim November 20, 2018
29. Pelgraz Peglgrastim September 21, 2018
30. Hulio Adalimumab September 17, 2018
31. Heya Adalimumab July 26, 2018
32. Hyrimoz Adalimumab July 26, 2018
33. Trazimera Trastuzumab Jul 26, 2018
34. Zessly Iniximab May 18, 2018
35. Kanjinti Trastuzumab May 16, 2018
36. Semglee Insulin glargine March 28, 2018
37. Herzuma Trastuzumab February 8, 2018
38. Mvasi Bevacizumab January 15, 2018
39. Ontruzant Trastuzumab November 15, 2017
40. Imraldi Adalimumab August 24, 2017
41. Insulin lispro Sano Insulin lispro July 18, 2017
42. Blitzima Rituximab July 13, 2017
43. Erelzi Etanercept June 23, 2017
44. Rixathon Rituximab June 15, 2017
45. Riximyo Rituximab June 15, 2017
46. Enoxaparin BECAT Enoxaparin sodium March 24, 2017
47. Amgevita Adalimumab March 21, 2017
48. Truxima Rituximab February 17, 2017
49. Movymia Teriparatide January 11, 2017
50. Terrosa Teriparatide January 4, 2017
51. Inhixa Enoxaparin sodium September 15, 2016
52. Flixabi Iniximab May 26, 2016
53. Benepali Etanercept January 13, 2016
54. Accol Filgrastim September 17, 2014
55. Abasaglar Insulin glargine September 9, 2014
56. Bemfola Follitropin alfa March 26, 2014
57. Grastol Filgrastim October 17, 2013
58. Ovaleap Follitropin alfa September 27, 2013
59. Inectra Iniximab September 10, 2013
60. Remsima Iniximab September 10, 2013
61. Nivestim Filgrastim June 7, 2010
62. Filgrastim Hexal Filgrastim February 6, 2009
63. Zarzio Filgrastim February 6, 2009
64. Ratiograstim Filgrastim September 15, 2008
65. Tevagrastim Filgrastim September 15, 2008
66. Retacrit Epoetin zeta December 18, 2007
67. Silapo Epoetin zeta December 18, 2007
68. Binocrit Epoetin alfa August 28, 2007
69. Abseamed Epoetin alfa August 27, 2007
70. Epoetin alfa Hexal Epoetin alfa August 27, 2007
71. Omnitrope Somatropin April 12, 2006

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Biosimilar Biopharmaceuticals
7
TABLE 1.3 (Continued)
Biosimilars Approved, Rejected, and Withdrawn in the European Union
No. Product Name Active Substance Authorization Date
Refused or withdrawn biosimilars in Europe
1. Alpheon Interferon alfa- 2a Refused on September 5, 2006
2. Biograstim Filgrastim September 15, 2008; withdrawn on December 22, 2016
3. Cyltezo Adalimumab November 10, 2017; withdrawn on January 15, 2019
4. Epostim Epoetin alfa Withdrawn March 15, 2011
5. Equidacent Bevacizumab September 24, 2020; withdrawn on November 23, 2021
6. Filgrastim ratiopharm Filgrastim September 15, 2008; withdrawn on April 20, 2011
7. Halimatoz Adalimumab July 26, 2018; withdrawn on January 29, 2021
8. Kromeya Adalimumab April 2, 2019; withdrawn on December 17, 2019
9. Lextemy Bevacizumab CHMP positive opinion February 25, 2021; withdrawn on
December 14, 2021
10. Lusduna Insulin glargine January 3, 2017; withdrawn on October 29, 2018
11. Qutavina Teriparatide August 27, 2020; withdrawn on January 18, 2021
12. Ritemvia Rituximab July 13, 2017; withdrawn on August 16, 2021
13. Rituximab Mabion Rituximab Withdrawn on March 16, 2020
14. Rituzena Rituximab July 13, 2017; withdrawn on April 10, 2019
15. Solumarv Insulin human Refused on February 11, 2016
16. Sondelbay Teriparatide Withdrawn on June 19, 2020
17. Solymbic Adalimumab March 22, 2017; withdrawn on March 5, 2019
18. Somatropin Biopartners Somatropin September 9, 2013; withdrawn on November 9, 2017
19. Thorinane Enoxaparin sodium September 14, 2016; withdrawn on October 24, 2019
20. Udenyca Peglgrastim September 21, 2018; withdrawn on February 15, 2021
21. Valtropin Somatropin April 24, 2006; withdrawn on May 10, 2012
Note: www.gab ionl ine.net/ bios imil ars/ gene ral/ bios imil ars- appro ved- in- eur ope.
TABLE 1.4
Potential Biosimilar Candidates
Abatacept Abciximab Aflibercept Alemtuzumab
Alirocumab Atezolizumab Avelumab Basiliximab
Bedinvetman (V) Belimumab Benralizumab Bevacizumab
Bezlotoxumab Blinatumomab Blood factors Brentuximab vedotin
Brodalumab Brolucizumab Burosumab Canakinumab
Caplacizumab Cemiplimab Certolizumab pegol Cetuximab
Crizanlizumab Daclizumab Daratumumab Darbepoetin alfa
Denosumab Dinutuximab Dupilumab Durvalumab
Eculizumab Elotuzumab Emapalumab Emicizumab
Erenumab Etanercept Evolocumab Follitropin alfa
Fremanezumab Frunevetmab (V) Galcanezumab Gemtuzumab ozogamicin
Golimumab Guselkumab Ibalizumab Idarucizumab
Inotuzumab ozogamicin Insulin detemir Insulin lispro Interferons
Ipilimumab Isatuximab Ixekizumab Lanadelumab
Lokivetmab (V) Mepolizumab Mogamulizumab Moxetumomab pasudotox
Muromonab- CD3 Natalizumab Necitumumab Nivolumab
(continued)
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