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Texas Oncology Reports Savings From Biosimilar Substitution Effort


The substitution program was carried out in 2020 and yielded savings of $4 million in 1 month, investigators reported at ASCO 2021.

An experiment with automatic prescribing of biosimilars at Texas Oncology resulted in a dramatic savings and increase in biosimilar vs originator usage rates, investigators reported at ASCO 2021.

Texas Oncology is a network of approximately 460 physicians and oncologists who serve patients with cancer in rural and urban communities throughout Texas.

A central pharmacy team reviewed all prescriptions and substituted biosimilars for originator biologics, unless payers insisted otherwise or the relevant biosimilar was not in the practice formulary. Texas Oncology also compiled a weekly report identifying all patients who would benefit from switching to biosimilars, and substitutions were then made. In collaboration with McKesson Specialty Health, patient and clinician education was incorporated into the biosimilar usage effort to improve results.

Texas Oncology began the substitution in July 2020 with rituximab and followed up in September 2020 and October 2020 with bevacizumab and trastuzumab substitutions, respectively. By December 2020, utilization of biosimilars rose to 80% from 5% for rituximab, 88% from 9% for bevacizumab, and 74% from 8% for trastuzumab.

Investigators calculated the potential savings per administration at $550 for bevacizumab, $850 for trastuzumab, and $1400 for rituximab. “In 1 month alone, this project dramatically reduced cost by $4 million or 21% by conversion to these 3 biosimilars,” they wrote.

The investigators also predicted that additional savings would be possible by using multidose vials of biosimilar product rather than single-dose vials.

“Our comprehensive team approach successfully deploys therapeutic interchange of biosimilars for brand drugs in a community oncology practice which leads to substantial cost savings. This has real implications in controlling the total cost of care,” the authors of the study wrote.


Wilfong L, Dave N, Garey JS, et al. A successful model of biosimilar adoption in a community oncology practice. Presented at: ASCO 2021: June 3-7, 2021. Abstract 6514.

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