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Budget Impact of Patient-Administered Biologic, Biosimilar for Patients With Non-Myeloid Malignancies

August 16, 2018

A budget impact analysis estimates the effective annual plan per-patient drug costs of a supportive care biologic and biosimilar to decrease significantly with respect to the original therapy.

Granulocyte colony-stimulating factors (G-CSFs) are often given to reduce the incidence, severity, and duration of febrile neutropenia in patients receiving chemotherapy. Tbo-filgrastim and filgrastim-sndz have shown comparable efficacy and safety to the short-acting granulocyte colony-stimulating filgrastim, though the budget impact of increased use of these products relative to filgrastim needs further research.

Holly Trautman, PharmD, MS, Aventine Consulting (Marblehead, MA), and colleagues conducted an analysis to estimate the budget impact of increasing use of patient-administered tbo-filgrastim and filgrastim-sndz from a US payer perspective. An interactive budget impact model was designed to estimate the changes in drug cost associated with projected increases in the market share of the products. Researchers used increases from 5% to 10% for tbo-filgrastim and 10% to 12% for filgrastim-sndz, along with a decrease in filgrastim market share from 85% to 78%, for a 1 million-member health plan among patients with non-myeloid malignancies receiving chemotherapy with a high risk of febrile neutropenia.

Researchers acknowledged that patient self-administration at home was assumed for 20% of patients receiving short-acting G-CSFs. The products were purchased through the patient’s pharmacy benefit and were assumed to have tier 3 formulary status with a patient copay of $54 per prescription.

The analysis was published in the Journal of Managed Care & Specialty Pharmacy (online August 2018; doi:10.18553/jmcp.2018.18094).

Results of the analysis showed the effective annual per-patient drug cost to the plan totaled between $16,961 and $27,199 for tbo-filgrastim. The per-patient drug costs to the plan were between $16,216 and $26,015 for filgrastim-sndz and between $19,134 and $30,663 for filgrastim.


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Furthermore, Dr Trautman and colleagues reported that the estimated total annual plan cost associated with patient-administered short-acting G-CSFs was $53,298,217 (per-member per-year, $53.30) in the current scenario and $52,828,832 (per-member per-year, $52.82) in the future scenario. Cost savings totaled $469,385 (per-member per-year, $0.48).

Authors of the study concluded that the effective annual plan per-patient drug costs for tbo-filgrastim and filgrastim-sndz were 11% and 15% lower, respectively, than filgrastim. “The present analysis estimated an annual US health plan cost savings approaching $0.5 million following increases in market shares of approximately 5% for tbo-filgrastim and 2% for filgrastim-sndz,” they wrote.—Zachary Bessette    

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