Table 1.

European initiatives on biosimilar prescribing incentives.

Country	Level	Incentive Program	Description
France [27]	National-Ministry of Health Hospital and retail pharmacies	Instruction no DSS/1C/DGOS/ PF2/2018/42 du 19 février 2018 relative à l’incitation à la prescription hospitalière de médicaments biologiques similaires […].	Hospitals can earn 20% or even 30% of the difference between the public price of the originator and its biosimilars.
Germany [28,29]	Regional-Saxonia Regional physician association and sick fund	“Biolike” initiative. Agreement between KV Westfalen-Lippe and sick fund Barmer.	Physicians who reach a certain biosimilar uptake are eligible to bill additional services for their patients.
Italy [30]	Regional-Campania Regional Health Service	DGR n.66 del 14.07.2016. Misure di incentivazione dei farmaci a brevetto scaduto e dei biosimilari. Monitoraggio delle prescrizioni attraverso la piattaforma Sani.ARP	Centres can earn 50% of the difference between the public price of the originator and its biosimilars to invest in high-cost innovator medicines; while a 5% will be invested back in the centre which generated the savings.
United Kingdom [31,32,33,34]	Local-Hospital Trusts and Clinical Commissioning Groups	Gainshare agreement between the Trust and the Clinical Commissioning Groups (50:50)	Hospitals can earn 50% of the difference between the public price of the originator and its biosimilars that are reinvested in patient care.