Budget impact analysis of pegfilgrastim biosimilar in the treatment of febrile neutropenia in Italy

Abstract

Introduction: Granulocyte-colony stimulating factors (G-CSFs) can significantly reduce the risk of febrile neutropenia (FN) among certain patients receiving chemotherapy. FN is associated with significant clinical and nonclinical complications. At present, the patent protection of pegfilgrastim (Neulasta®) has expired, and a biosimilar (Ziextenzo®) has been approved. Since the biosimilar price is expected to be lower as compared with the originator’s, the present Drug Budget Impact analysis tries to evaluate whether and how much profitable the biosimilar availability will be for the Italian NHS, in terms of cost containment (savings).Methods and Results: The model time horizon extends to five years. The initial overall number of treatments with pegfilgrastim is estimated based on the number of pegfilgrastim packages (assuming a recommended dose of 6 mg is administered after each cytotoxic chemotherapy) and kept constant in time. The model assumes that, year by year, the number of treatments with the originator will partly switch to the biosimilar (according to an uptake rate assumed). The results show that the availability of the biosimilar would provide an €6.4 million cumulated savings to the NHS in the five years.Conclusions: According to the present analysis, the availability of the biosimilar would generate cumulated savings (in five years) as high as €6.4 million for the Italian NHS. 
 (HTA & Market Access)

Budget Saving Potential of Pegfilgrastim Biosimilar for the Treatment of Chemotherapy-Induced Febrile Neutropenia, in Italy

“…The analysis highlighted the economic advantage of using pegfilgrastim biosimilars in place of SA G-CSF treatments in the FN treatment setting, providing a substantial cumulative A confirmation of our analysis comes from the results of a budget impact model built by Ravasio et al [21] in order to assess the economic impact generated in Italy from the use of the pegfilgrastim biosimilar compared to the originator. These authors showed that the availability of the biosimilar could (in five years) generate cumulated savings as high as € 6.4 million for the whole Italian NHS [21]. However, this analysis did not calculate the potential savings of the introduction of pegfilgrastim biosimilar to the local formulary, compared to SA and LA G-CSFs currently used for FN prophylaxis.…”

“…The recent licensing in Europe of biosimilar pegfilgrastim-containing products offers the opportunity to deliver the additional advantages of long-over short-acting G-CSF at a reduced cost. For countries currently using reference pegfilgrastim, evident cost savings are reported by switching to biosimilar pegfilgrastim [18,20,21].…”

“…However, with the introduction of biosimilar G-CSFs, significant cost savings with the same quality of care may be achieved. In Italy, pegfilgrastim biosimilars, available since 2019, offer clinical and economic benefits in FN management [18][19][20][21].…”