Savings From Biosimilar Filgrastim Can Expand Access to High-Cost Drugs

Savings generated by the use of biosimilars can be reallocated to provide other treatments, including expensive and recently approved novel therapies, to the same or different patients. At the American Society of Hematology’s 59th Annual Meeting and Exposition in Atlanta, Georgia, Sanjeeev Balu, PhD, will present results of a study that examines expanded access to the drug obinutuzumab (Gazyva) made possible on a budget-neutral basis through savings obtained from using biosimilar filgrastim-sndz (Zarxio).¹

The study estimated the cost-savings that could be achieved from converting febrile neutropenia prophylaxis from reference filgrastim (Neupogen) or pegfilgrastim (Neulasta) to the biosimilar filgrastim, and simulated a hypothetical reallocation of those savings to therapeutic care with obinutuzumab (a humanized anti-CD20 monoclonal antibody approved in 2016 for relapsed or refractory follicular lymphoma).

Using the assumption of therapeutic similarity of filgrastim, pegfilgrastim, and biosimilar filgrastim, a simulation analysis was performed using the average selling price cost for 1 patient for 1 chemotherapy cycle with 5, 7, 11, and 14 days of prophylaxis. This study was performed with a 20,000-patient panel.

Per-cycle cost savings from utilizing biosimilar filgrastim over filgrastim are $327 (5-day prophylaxis), $457 (7-day), $719 (11-day), and $915 (14-day ). For 20,000 patients, conversion from filgrastim to biosimilar filgrastim yields savings of approximately $6,540,000 (5-day prophylaxis), $9,156,000 (7-day), $14,388,000 (11-day), and $18,312,000 (14-day). These savings provide expanded access to obinutuzumab treatment to 60, 85, 133, and 169 patients, respectively.

As conversion-related savings relative to pegfilgrastim decline as daily injections increase, for 20,000 patients, conversion from pegfilgrastim to the biosimilar filgrastim yields savings of $55,893,600 (5-day prophylaxis), $47,177,600 (7-day), $29,745,600 (11-day), and $16,671,600 (14-day). These studies provide expanded access to obinutuzumab treatment to 516, 435, 275, and 154 patients, respectively.

The results of the study show that converting from reference filgrastim and pegfilgrastim to biosimilar filgrastim yields significant savings, especially when converting from pegfilgrastim. Conversion to biosimilar growth factors for prophylaxis of febrile neutropenia in large payer panels can create substantial savings that enable more patients with hematological malignancies to be treated without an additional cost to payers.

Reference

1. McBride A, Campbell K, Bikkina M, MacDonald K, Abraham I, Balu S. Expanded access to obinutuzumab from cost-savings generated by biosimilar filgrastim-sndz in the prophylaxis of chemotherapy-induced (febrile) neutropenia: US simulation study. Presented at the American Society of Hematology 59th Annual Meeting and Exposition 2017, December 10, 2017; Atlanta, Georgia. Abstract 3380. https://ash.confex.com/ash/2017/webprogram/Paper105737.html