“…Over a decade ago, after the European approval of biosimilar epoetin alfa (Binocrit R ) and biosimilar filgrastim (Zarzio R ), both manufactured by Sandoz (Holzkirchen, Germany), the authors initiated a series of cost-efficiency studies of the cost-savings associated with conversion from originator to biosimilar products, starting with biosimilars in supportive cancer care (epoetin alfa, filgrastim, pegfilgrastim) [19][20][21][22][23][24][25][26][27][28] and, more recently, anticancer therapy with biosimilar trastuzumab [29]. Importantly these cost-efficiency analyses were complemented with simulations of the expanded access that could be purchased on a budget-neutral basis to (then) novel anticancer agents and regimens (rituximab, trastuzumab, obinutuzumab, pembrolizumab and R-CHOP [rituximab, doxorubicin, cyclophosphamide, vincristine, and prednisone]), as well as expanded access to additional biosimilar GCSFs.…”