Chemotherapy-induced febrile neutropenia prophylaxis with pegfilgrastim-bmez increases the value of cancer care and generates significant cost-savings over the reference product, improving access to care for these patients (J Med Econ. 2020;1-8. doi:10.1080/13696998.2020.1760284).
Ali McBride, Arizona Cancer Center, Banner University Medical Center, Tucson, Arizona, and colleagues conducted an economic analysis evaluating the effects of converting to biosimilar pegfilgrastim-bmez from the reference product.
The aims of the analysis were to model the cost-efficiency of prophylaxis with biosimilar pegfilgrastim-bmez for chemotherapy-induced febrile neutropenia compared to reference pegfilgrastim, as well as the expanded access to chemotherapy-induced febrile neutropenia prophylaxis and anti-neoplastic treatment that could be achieved with biosimilar cost-savings on a budget-neutral basis.
Dr McBride and colleagues conducted an ex ante simulation from the payer perspective of the cost-savings of 10–100% conversion from reference to biosimilar pegfilgrastim-bmez using drug price discounting ranging from 10–35% in a hypothetical panel of 20,000 patients receiving prophylaxis for chemotherapy-induced febrile neutropenia. The average sales price for pegfilgrastim in the second quarter of 2019 was used.
Additionally, researchers estimated the budget-neutral expanded access to biosimilar pegfilgrastim-bmez enabled by these cost-savings and estimated the budget-neutral expanded access to anti-neoplastic treatment with pembrolizumab.
These simulations were replicated using fourth quarter 2019 wholesale acquisition cost for reference pegfilgrastim and biosimilar pegfilgrastim-bmez in a post facto analysis.
In average sales price simulations, the cost-savings associated with pegfilgrastim-bmez in a 20,000 patient panel range from $1.3M (at 15% price discount) to $3 M (at 35% discount) at 10% conversion rate and from $6.4M to $14.9 M, respectively, at 50% conversion.
Dr McBride and colleagues noted that these savings could provide prophylaxis with pegfilgrastim-bmez to an additional 352 (15% discount) to 1,076 patients (35%) at 10% conversion or 1,764–5,384, respectively, at 50% conversion, over reference pegfilgrastim. Alternatively, these savings could be reallocated for anti-neoplastic treatment with pembrolizumab for 3 (15% discount) to 9 (35% discount) patients at 10% conversion or 19 to 45 patients, respectively, at 50% conversion.
When utilizing wholesale acquisition cost, the cost-savings range from $4.6M at 10% conversion to $23.1 M at 50% conversion, which could provide pegfilgrastim-bmez to an additional 1,174 to 5,873 patients, respectively.
“Prophylaxis with biosimilar pegfilgrastim-bmez increases the value of cancer care by generating significant cost-savings that could be reallocated to provide expanded access to [chemotherapy-induced febrile neutropenia] prevention and anti-neoplastic therapy on a budget-neutral basis,” Dr McBride and colleagues concluded.—Janelle Bradley
