Conversion from Filgrastim to Tbo-filgrastim: Experience of a Large Health Care System

Agboola, Foluso

doi:10.18553/jmcp.2017.23.12.1214

Cited by 6 publications

(11 citation statements)

References 14 publications

(25 reference statements)

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“…A study by Grabowski et al reported that Sweden and Germany observed fast uptake of a filgrastim biosimilar, while Italy, France, and the United Kingdom lagged behind [9]. Uptake can also be highly variable even within a single healthcare system, as one study observed that 90% of inpatients in eastern Massachusetts used the biosimilar tbo-filgrastim, compared to only 50% of outpatients [10]. It is unsurprising that biosimilars have not been able to penetrate the Canadian market as generic drugs do, given their complexity, lack of interchangeability, and lower discounting than in other countries [3].…”

Section: Discussionmentioning

confidence: 99%

Potential cost-savings from the use of the biosimilars filgrastim, infliximab and insulin glargine in Canada: a retrospective analysis

Mansell

Bhimji

Eurich

et al. 2019

BMC Health Serv Res

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BackgroundIn 2014 and 2015, biosimilars for the drugs filgrastim, infliximab, and insulin glargine were approved for use in Canada. The introduction of biosimilars in Canada could provide significant cost savings for the Canadian healthcare system over originator biologic drugs, however it is known that the use of biosimilars varies widely across the world. The aim of this study was to estimate the use of biosimilars in Canada and potential cost-savings from their use.MethodsWe performed a retrospective analysis of Canadian drug purchases for filgrastim, infliximab, and insulin glargine from July 2016 to June 2018. This was a cross-sectional study and the time horizon was limited to the study period. As a result, no discounting of effects over time was included. Canadian drugstore and hospital purchases data, obtained from IQVIA™, were used to estimate the costs per unit and unit volume for biosimilars and originator biologic drugs within each province. Potential cost-savings were calculated as a product of the units of reference originator product purchased and the cost difference between the originator biologic and its corresponding biosimilar.ResultsThe purchase of biosimilars varied by each province in Canada, ranging from a low of 0.1% to a high of 81.6% of purchases. In total, $1,048,663,876 Canadian dollars in savings could have been realized with 100% use of biosimilars over the originator products during this 2 year time period. The potential savings are highest in the province of Ontario ($349 million); however, even in smaller markets (PEI and Newfoundland), $28 million could have potentially been saved. Infliximab accounted for the vast majority of the potential cost-savings, whereas the purchases of the biosimilar filgrastim outpaced that of the originator drug in some provinces. In sensitivity analyses assuming only 80% of originator units would be eligible for use as a biosimilar, $838 million dollars in cost savings over this two-year time period would still have been realized.ConclusionsThe overall use of biosimilar drugs in Canada is low. Policy makers, healthcare providers, and patients need to be informed of potential savings by increased use of biosimilars, particularly in an increasingly costly healthcare system.

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Section: Discussionmentioning

confidence: 99%

Potential cost-savings from the use of the biosimilars filgrastim, infliximab and insulin glargine in Canada: a retrospective analysis

Mansell

Bhimji

Eurich

et al. 2019

BMC Health Serv Res

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“…While biosimilar products are highly similar to their reference product, they are not currently considered interchangeable and cannot be substituted without intervention of the prescriber [71]. Furthermore, it is important to note that tbo-filgrastim was approved in Europe as a biosimilar in 2008; however, in the United States, it was approved in 2012 as a biologic product because it was filed under a Biologics License Application since the biosimilars pathways was not established at the time of FDA submission [72].…”

Section: Current Strategies To Prevent and Treat Cin And Improve Rdimentioning

confidence: 99%

Prophylaxis and treatment strategies for optimizing chemotherapy relative dose intensity

Shayne

Harvey

Lyman

2021

Expert Review of Anticancer Therapy

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Introduction: A decrease in relative-dose intensity (RDI) of chemotherapy has been shown to be associated with poor patient outcomes in solid tumors and non-Hodgkin's lymphoma. The actual delivered chemotherapy dose received by patients can be influenced by dose reductions and treatment delays, often due to toxicities, most commonly chemotherapy-induced neutropenia (CIN). Areas covered: We review seminal evidence and more recent studies that have shown an association between higher RDI and improved patient survival. A smaller number of studies has shown no association between RDI and outcomes. These differences may be due to study limitations, including low power, differences in patient and disease characteristics, or the chemotherapeutic regimen. We describe guidelines recommendations to prevent and treat CIN with granulocyte-colony stimulating factor (G-CSF) and describe novel approaches to prevent neutropenia that are being developed that may provide greater value and be associated with fewer adverse events than standard G-CSF options. Expert opinion: Maintaining RDI is important to ensure optimal patient outcomes. This can be achieved through the proper administration of G-CSF prophylaxis and treatment. Newer agents in development to treat and/or prevent CIN are entering regulatory review and may potentially change the treatment landscape for CIN in the future.

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“…4,5 Previous publications have described barriers to biosimilar uptake. 6,7 Despite there being no expected difference in effectiveness between a biosimilar and its originator product, prescribers have limited comfort and confidence when biosimilars enter the market. 6,8 This lack of uptake may be more discernible when products are being prescribed for "at-risk" patient populations, for which there is a lack of data in the studies submitted for approval of the biosimilars.…”

Section: Introductionmentioning

confidence: 99%

Effect on Patients’ Outcomes of a Change to Biosimilar Filgrastim Product in Autologous Stem Cell Mobilization

Fenna

Guirguis

Ibrahim

et al. 2021

CJHP

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Background: Following addition of a biosimilar filgrastim product to the formulary, sites in the authors’ provincial health authority transitioned from using the originator filgrastim to the biosimilar for autologous stem cell mobilization. Objective: To assess the effect on patient outcomes of a universal change to use of the biosimilar filgrastim in stem cell mobilization. Methods: This retrospective pre–post study included patients undergoing autologous stem cell mobilization at 2 cancer hospitals in Alberta, Canada, between July 1, 2018, and November 30, 2019. Clinical outcomes were investigated for patients treated with a granulocyte colony-stimulating factor (biosimilar or originator product) for mobilization before stem cell transplant, approximately 6 months before and after the defined date of product change. Results: In total, 102 patients were treated with the originator product and 101 patients with the biosimilar. Effectiveness was similar between the originator and biosimilar products, with 98% successful harvest of stem cells in all patients treated. Independent t tests showed no statistically significant differences between patients receiving the originator and those receiving the biosimilar in terms of time from mobilization to collection (difference of means –0.9 days, 95% confidence interval [CI] –2.12 to 0.32), time for neutrophil engraftment (difference of means 0 days, 95% CI –0.36 to 0.36), time for platelet engraftment (difference of means 1 day, 95% CI –0.55 to 2.55), average length of stay (difference of means –0.7 day, 95% CI –2.71 to 1.31), and CD34+ value (difference of means –1 × 106/kg body weight, 95% CI –2.11 to 0.11). A 98% rate of conversion to use of the biosimilar filgrastim was achieved, with an estimated annual drug-cost saving of $67 500. Conclusions: In this pre–post study, changing to the biosimilar product from the originator maintained clinical effectiveness outcomes while decreasing overall drug expenditures. A well-planned change to the biosimilar product, executed in conjunction with clinician consultation and monitoring of effectiveness outcomes, can ensure appropriate patient therapy while significantly improving the uptake of biosimilars and decreasing expenditures for biologic drugs. RÉSUMÉ Contexte : À la suite de l’ajout d’un produit filgrastim biosimilaire à la liste des médicaments, les sites relevant de l’autorité sanitaire provinciale des auteurs sont passés de l’utilisation du filgrastim princeps à la version générique pour la mobilisation des cellules souches autologues. Objectif : Évaluer l’effet sur les résultats des patients d’un changement généralisé visant à utiliser le filgrastim générique pour la mobilisation des cellules souches. Méthodes : Cette étude rétrospective pré-post comprenait des patients soumis à une mobilisation des cellules souches autologues dans deux hôpitaux de cancérologie en Alberta (Canada) entre le 1er juillet 2018 et le 30 novembre 2019. L’examen des résultats cliniques des patients traités à l’aide d’un facteur stimulant les colonies de granulocytes (G-CSF) (générique ou princeps) pour une mobilisation avant la greffe de cellules souches a eu lieu environ six mois avant et après la date du changement de produit. Résultats : Au total, 102 patients ont été traités à l’aide du produit princeps et 101 patients à l’aide du générique. Les deux produits présentaient une efficacité similaire, et 98 % de réussite dans la récolte de cellules souches chez tous les patients traités. Des tests t indépendants n’ont montré aucune différence statistique significative entre les patients recevant le princeps et ceux recevant le biosimilaire en termes de temps allant de la mobilisation à la collecte (différence des moyennes –0,9 jour, intervalle de confiance [IC] 95 % –2,12 à 0,32); temps de la prise de la greffe neutrophile (différence des moyennes 0 jour, IC 95 % –0,36 à 0,36); temps de la prise de la greffe des plaquettes (différence des moyennes 1 jour, IC 95 % –0,55 à 2,55); durée moyenne du séjour (différence des moyennes –0,7 jour, IC 95 % –2,71 à 1,31) et valeur CD34+ (différence des moyennes –1 × 106/kg masse corporelle, IC 95 % –2,11 à 0,11). Un taux de conversion de 98 % visant à utiliser le filgrastim générique a été atteint, avec une estimation des économies annuelles sur le coût des médicaments de 67 500 $. Conclusions : Dans cette étude pré-post, le passage du produit princeps au générique a préservé l’efficacité des résultats cliniques, tout en diminuant les dépenses générales liées au médicament. Un changement bien programmé pour passer au produit générique, mené conjointement avec la consultation d’un clinicien et un contrôle des résultats d’efficacité, peut assurer une thérapie du patient appropriée tout en améliorant grandement la prise de produits génériques et en diminuant les dépenses associées aux médicaments biologiques.

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Conversion from Filgrastim to Tbo-filgrastim: Experience of a Large Health Care System

Cited by 6 publications

References 14 publications

Potential cost-savings from the use of the biosimilars filgrastim, infliximab and insulin glargine in Canada: a retrospective analysis

Potential cost-savings from the use of the biosimilars filgrastim, infliximab and insulin glargine in Canada: a retrospective analysis

Prophylaxis and treatment strategies for optimizing chemotherapy relative dose intensity

Effect on Patients’ Outcomes of a Change to Biosimilar Filgrastim Product in Autologous Stem Cell Mobilization

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