Studies have demonstrated that using follow-on and biosimilar granulocyte colony-stimulating factor (G-CSF) agents can produce cost savings and expand patient access to prophylaxis of febrile neutropenia. Now, a newly published budget impact analysis finds that even greater savings may be possible if patients self-administer these agents at home rather than visiting a provider to receive an injection.
Studies have demonstrated that using follow-on and biosimilar granulocyte colony-stimulating factor (G-CSF) agents can produce cost savings and expand patient access to prophylaxis of febrile neutropenia. Now, a newly published budget impact analysis finds that even greater savings may be possible if patients self-administer these agents at home rather than visiting a provider to receive an injection.
To date, 3 short-acting G-CSF drugs are available in the United States: the innovator product (Neupogen), a follow-on product (tbo-filgrastim, Granix), and a biosimilar (Zarxio). The budget impact analysis sought to estimate the change in cost associated with increased use of Granix and Zarxio from the perspective of a health plan covering 1 million members over a 1-year time horizon.
Click to read more about tbo-filgrastim.
Drawing on rates shown in the available literature, the investigators assumed that 45% of eligible patients would use any G-CSF, and 70% of that group would use a short-acting product. Finally, they assumed that 20% of patients would self-administer their drug at home. Drawing on current market share distributions of G-CSFs from IMS Health data, the share of market for self-administered products was assumed to be 4.9% for Granix, 84.7% for Neupogen, and 10.4% for Zarxio. The investigators also projected a future 5% increase in market share for Granix and a 2% increase in market share for Zarxio.
The base-case budgetary impact analysis estimated that the total plan cost for short-acting G-CSF was $53,298,217 for a 1-million-member plan, with Granix costing $2,311,211, Neupogen costing $46,037,202, and Zarxio costing $4,949,804. Assuming the projected future increases for Granix and Zarxio, the total cost dropped to $52,828,832 (with Granix costing $4,703,546, Neupogen costing $42,260,349, and Zarxio costing $5,864,937), resulting in a total plan cost savings of $469,385.
Because Granix can be stored at room temperature for up to 5 days (versus 1 day for Neupogen and Zarxio), it may be subject to less wastage, so the investigators also conducted a scenario analysis evaluating how annual syringe replacement rates (assuming a 1% replacement rate for Granix and 5% replacement rates for the other 2 products) affected costs. The estimated total annual plan cost associated with short-acting G-CSF agents was $55,920,046 in this scenario; however, assuming future increased market share for Granix and Zarxio, the cost dropped to $55,346,277.
The model was most sensitive to changes in the percentage of patients who self-administered their G-CSF agent at home; assuming a 25% increase in home use, total plan costs increased to $66,042,135 for the future scenario, while a 25% reduction in home use led to a decrease to $39,615,529.
“However,” the authors write, “it is important to note that any changes in plan costs associated with a larger number of patients self-administering G-CSF would be largely offset by reduced costs associated with the smaller number of patients undergoing chemotherapy who would receive their short-acting G-CSF treatment directly from a health care provider in an office or other outpatient setting.”
The analysis concluded that the effective annual plan per-patient drug cost was 11% lower for Granix and 15% lower for Zarxio than the cost of the reference, and increased market share of these products could lead to total annual plan cost decreases of nearly $0.5 million. Because replacement due to wastage tempered these savings, increasing the use of Granix and Zarxio over Neupogen for those who self-administer “may offer a more affordable option for US payers.”
Reference
Trautman H, Szabo E, James E, Tang B. Patient-administered biologic and biosimilar filgrastim may offer more affordable options for patients with nonmyeloid malignancies receiving chemotherapy in the United States: a budget impact analysis from the payer perspective. [Published online August 7, 2018.] J Manag Care Spec Pharm. doi: 10.18553/jmcp.2018.18094.
Biosimilars Oncology Roundup for June 2024—Podcast Edition
July 7th 2024On this episode of Not So Different, we review biosimilar news coming out of June, with clinical trial results from conferences and a study showcasing how to overcome economic and noneconomic barriers to oncology biosimilars.
A New Chapter: How 2023 Will Shape the US Biosimilar Space for 2024 and Beyond
December 31st 2023On this episode of Not So Different, Cencora's Brian Biehn and Corey Ford take a look back at major policy and regulatory advancements in 2023 and how these changes will alter the space going forward.
Eye on Pharma: BI Cyltezo Partnership; Europe Ustekinumab Launch; Mexico Biosimilar Approval
July 24th 2024Boehringer Ingelheim (BI) partners with GoodRx to offer its unbranded adalimumab biosimilar to patients at an exclusive low price; a new ustekinumab biosimilar launches in Europe; and Mexican officials approve a bevacizumab biosimilar.