Unlocking Cost-Efficiency and Access With Biosimilar Bevacizumab in Medicare

New research explores the cost-efficiency and expanded access of biosimilar bevacizumab in Medicare for patients with metastatic colorectal (mCRC) and non-small cell lung cancer (mNSCLC), revealing substantial cost savings and potential for treating additional patients on a budget-neutral basis.

Bevacizumab, a VEGF inhibitor originally approved for metastatic colorectal cancer, is now used for various solid tumor indications including mCRC and mNSCLC. Biosimilar competitors entered the market in 2019, offering lower prices and similar efficacy and safety compared to the reference product. Medicare, a major payer for bevacizumab treatment, could see significant cost-savings from switching to biosimilars, allowing for expanded patient access within a fixed budget. Cost-efficiency analysis is utilized to assess the potential cost savings and increased patient access by transitioning to biosimilar bevacizumab, specifically focusing on maximizing outcomes and budget utilization. 

A Medicare payer perspective simulation model was developed to estimate cost savings from switching from bevacizumab to alternative biosimilars for patients with mCRC and mNSCLC. The target patient population for annual first-line systemic therapy was determined using Medicare enrollment data and cancer incidence rates in patients 65 years and older. Recent evidence suggests that a significant percentage of new diagnoses for mCRC and mNSCLC receive systemic therapy with bevacizumab-based regimens. Costs were calculated based on the 2024 average sales price (ASP), with results showing potential per-patient per-month savings and the number needed to convert to a biosimilar to fund treatment for additional patients.

Results showed significant cost savings in treating mCRC with bevacizumab-bvzr compared to alternative biosimilars. In the base case scenario for mCRC, monthly savings were $27 664 432, representing a 68% reduction in cost. Scenario analyses for a 50% biosimilar conversion showed monthly savings of $13 832 216. For mNSCLC, monthly savings with bevacizumab-bvzr were $32 319 323 in the base case, a 70% reduction in cost. The potential monthly savings from total biosimilar conversion could fund additional patient months of treatment with bevacizumab-bvzr combinations.

“In the first cost-efficiency and expanded access study of biosimilar bevacizumab in mCRC and mNSCLC, we find that bevacizumab-bvzr-based regimens can result in substantial cost savings relative to originator-based first line treatment in Medicare,” said researchers. “These cost savings could be reinvested to treat a substantial number of additional patients with mCRC or mNSCLC, or fund other costs of care in Medicare, on a budget-neutral basis.” 

Reference 
Roth J A, Kratochvil D, Dorman S, Bernauer M. Cost-efficiency and expanded access modeling of conversion to biosimilar bevacizumab in metastatic colorectal and non-squamous non-small cell lung cancer in Medicare. J Med Econ. 2025;28(1):378–386. doi:10.1080/13696998.2025.2474884