Expanded access to cancer treatments from conversion to neutropenia prophylaxis with biosimilar filgrastim-sndz

Abstract

Aim: Biosimilar medicines offer significant cost-savings potential over their reference products, which can be re-allocated to provide access to other cancer treatments on a budget-neutral basis. Methods: Simulation study using cost data for the USA under consideration of several prophylaxis patterns. Results: Potential savings from conversion from reference filgrastim to biosimilar filgrastim-sndz are significant. These savings expand budget-neutral access to novel immunotherapies (obinutuzumab; pembrolizumab) or supportive care (filgrastimsndz). Conclusion: The combination of biosimilar savings and expanded access increases the value of cancer care as the same supportive care is provided at lower cost, additional cancer care is enabled at no additional cost, and more patients will have access to cancer care.

Economic modeling for the US of the cost-efficiency and associated expanded treatment access of conversion to biosimilar pegfilgrastim-bmez from reference pegfilgrastim

“…In first instance, this is a financial decision. As our present and prior 12,13,15 expanded access analyses show, additional patients can be treated on a budget-neutral basis, whether with therapeutic cancer treatments, supportive cancer treatments, or both. This benefit extends beyond provider and payer, but also has a societal benefit as it improves the population's access to cancer care and thus reduces the societal burden of cancer 12 .…”

“…As we have shown previously in our program of pharmacoeconomic analyses of biosimilar growth factors in Europe [10][11][12][13] and the US [14][15][16] , conversion from reference to biosimilar agents in supportive cancer care affords significant cost-savings. Moreover, these savings can be reallocated on a budget-neutral basis to fund expanded patient access to anti-cancer treatment with expensive therapeutic regimens or to additional CIN/FN prophylaxis.…”

“…As we noted in our simulation study of expanded access from conversion to standard biosimilar filgrastim, combining biosimilar utilization and expanded access impacts the value equation in two important ways 15 . First, it affects the cost-tooutcome ratio: "the health outcomes achieved per dollar spent or conversely how much it costs to achieve 1 unit of outcome, such as a CIN/FN episode or a CIN/FIN-related hospitalization averted" (p. 2292) 15 . Second, it influences the cost-to-access ratio: "how much it costs to provide one patient with access" (p. 2292) to supportive or therapeutic cancer therapy 15 .…”

“…Moreover, these savings can be reallocated on a budget-neutral basis to fund expanded patient access to anti-cancer treatment with expensive therapeutic regimens or to additional CIN/FN prophylaxis. For instance, in the US, savings from prophylaxis with biosimilar filgrastim-sndz (Zarxio i ) in a hypothetical panel of 20,000 cancer patients receiving one cycle of GCSF support could provide, on a budget-neutral basis, between 169 and 544 patients with relapsing/refractory follicular lymphoma with treatment with obinutuzumab or an additional 60-192 patients with nonsmall cell lung cancer with access to pembrolizumab 15 . Alternatively, the savings could provide CIN/FN prophylaxis with biosimilar filgrastim-sndz to 2,801-9,017 cycles of myelosuppressive chemotherapy, again on a budget-neutral basis.…”

“…Alternatively, the savings could provide CIN/FN prophylaxis with biosimilar filgrastim-sndz to 2,801-9,017 cycles of myelosuppressive chemotherapy, again on a budget-neutral basis. Novel in these analyses 12,13,15 is the concept of number-needed-to-convert (NNC): the number of patients that need to be converted from a reference biological to its biosimilar to purchase budget-neutrally one unit of expanded access to a target treatment.…”