Switching patients with cancer to biosimilar pegfilgrastim for prophylaxis treatment of chemotherapy-induced febrile neutropenia could generate significant savings for adjuvant treatment, investigators found in studies presented at ASCO20 Virtual, the annual meeting of the American Society of Clinical Oncology (ASCO).
Switching patients with cancer from reference pegfilgrastim (Neulasta) to biosimilar pegfilgrastim (Udenyca) not only reduces the cost of prophylaxis treatment for chemotherapy-induced febrile neutropenia (FN) but also provides funds for adjuvant treatment, according to findings presented at ASCO20 Virtual, the annual meeting of the American Society of Clinical Oncology.
Below is a summary of these findings.
Biosimilar Pegfilgrastim Cost-Effectiveness
A cost-efficiency analysis based on current average sales prices indicated potential cost savings per patient treated with biosimilar pegfilgrastim versus reference pegfilgrastim with or without the on-body injector (Onpro) ranged from $223 for 1 cycle to $1335 for 6 cycles.1
Study results from a panel of 20,000 patients with cancer showed that the savings generated from 1 cycle of pegfilgrastim prophylaxis with 10% of patients converted to the biosimilar would be $445,163. For 6 cycles of pegfilgrastim with 100% of patients using biosimilar pegfilgrastim, savings jumped to $26,709,788.
Based on single cycles of chemotherapy for the population cohort, the potential savings from biosimilar prophylaxis translate into expanded access of 115 additional doses at 10% conversion from the reference product and 1154 doses at 100% conversion.
The savings compounded over 6 cycles of chemotherapy could provide 692 additional doses of biosimilar pegfilgrastim at 10% conversion. If 100% of patients at risk of chemotherapy-induced FN switched, savings over 6 cycles could provide 6921 additional doses.
The number of patients needed to convert from the reference product to cover the cost of 1 additional dose of biosimilar pegfilgrastim is 18, according to the study.
Expanded Access to Adjuvant Therapy
Using the same payment-focused model, researchers expanded these potential savings of switching to the biosimilar from the reference product and extrapolated to the adjuvant chemotherapy (doxorubicin or cyclophosphamide) setting.2
If 10% of patients in the cohort of 20,000 converted to biosimilar pegfilgrastim, over 1 cycle of chemotherapy the same savings from the earlier study could pay for 1286 single cycles of additional chemotherapy. Additionally, 12,861 additional cycles would be generated if 100% of patients at risk of FN converted.
The savings over 6 cycles of chemotherapy could provide between 7717 additional cycles of doxorubicin/cyclophosphamide at 10% conversion to biosimilar pegfilgrastim in the chemotherapy-induced FN risk group and 77,166 cycles at 100% conversion.
Only 2 patients would be needed to convert to the biosimilar from reference pegfilgrastim to provide savings enough for 1 additional cycle of doxorubicin/cyclophosphamide.
“These savings could be reallocated to provide access to curative anti-neoplastic treatment on a budget-neutral basis, thus enhancing the value of cancer care to both payers and patients,” the investigators wrote.
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1. Mcbride A, MacDonald K, Abraham I. Simulation modeling of cost-savings from conversion of pegfilgrastim to biosimilar pegfilgrastim-cbqv for the prophylaxis of chemotherapy-induced (febrile) neutropenia (CIN/FN) and expanded access to biosimilar prophylaxis. Presented at ASCO20 Virtual; May 30-31, 2020. Abstract e19372. meetinglibrary.asco.org/record/190726/abstract.
2. Mcbride A, MacDonald K, Abraham I. Simulation modeling of budget-neutral expanded access to antineoplastic therapy from cost-savings derived from conversion to biosimilar pegfilgrastim-cbqv for the prophylaxis of chemotherapy-induced (febrile) neutropenia (CIN/FN) in early-stage breast cancer. Presented at ASCO20 Virtual; May 30-31, 2020. Abstract e19371. meetinglibrary.asco.org/record/190413/abstract.