Tbo-Filgrastim Shows Significant Cost Saving for Payers

Boston—A pharmacy budget impact model (BIM) to estimate, from a payer perspective, the impact of the introduction of tbo-filgrastim as an alternative short-acting granulocyte colony-stimulating factor (G-CSF) on a pharmacy budget showed a total annual plan cost savings of >$2 million, according to a study presented at the AMCP meeting during a poster session titled Tbo-filgrastim Budget Impact Analysis.

Tbo-filgrastim is an alternative to filgrastim for chemotherapy-induced neutropenia in patients treated with myelosuppressive chemotherapy at a ≥20% risk of febrile neutropenia. G-CSFs are used prophylactically to reduce the duration of severe neutropenia and the rate of infection with chemotherapy by stimulating neutrophil proliferation, differentiation, and activation. Studies have shown that tbo-filgrastim and filgrastim are effective and well-tolerated; however, a comparison of costs for these 2 agents has not previously been conducted.

The pharmacy BIM was conducted using a theoretical 1 million member health plan and developed using a Microsoft® Excel model, allowing users to customize inputs to reflect health plan characteristics, estimate total health plan pharmacy costs, and access the difference in utilization costs between filgrastim only and the introduction of tbo-filgrastim. Annual wholesale acquisition cost (WAC) was calculated based on 10 doses per package for 1 dose per day for 10 days of chemotherapy for an average of 6 cycles per year. The model was set to predict a future market share of 10% for tbo-filgrastim and 90% for filgrastim. The proportion of patients receiving G-CSF injection by a healthcare provider was set at 100% for tbo-filgrastim (based on Prescribing Information) and 73% for filgrastim (based on utilization data).

The results showed that annual costs for the tbo-filgrastim 10 dose package was lower compared with the 10 dose package of filgrastim prefilled syringes or vials ($3525 vs $4939 and $4659, respectively), which is an initial cost difference of ≥18% for tbo-filgrastim versus filgrastim. For plan costs, tier 3 formulary status was assumed, and the results showed that both agents, in general, had the same plan-related costs. Copayment costs were $51, copayment per year costs were $306, and administrative costs were $26 (based on 2013 Medicare Physician Fee Schedule payment rates).

The annual WAC was also lower for tbo-filgrastim ($24,196) compared with filgrastim vials and prefilled syringes ($28,779 and $30,462, respectively). The base case pharmacy budget impact analysis determined that the current US annual plan cost for filgrastim was estimated at $120,242,621. This data suggests that if the market share for tbo-filgrastim grows to 10% while the market share for filgrastim drops to 90% within a 1 million member health plan, the total annual plan costs are estimated to decrease by >$2 million, with an approximate 2% cost savings for members on a monthly and annual basis.

“These cost savings, achieved in the context of similar efficacy and safety, provide an incentive for pharmacy plans to prescribe tbo-filgrastim as a preferred treatment option,” the researchers concluded.—Eileen Koutnik-Fotopoulos

This study was supported by Teva Pharmaceuticals, Inc.