Cost-effective cancer care: The role of oncology biosimilars in generating cost savings.

Abstract

11033 Background: Biosimilar versions of biologic drugs (reference drugs) present a promising opportunity to reduce healthcare costs. Although not labeled as directly interchangeable, biosimilars are considered reasonable alternatives to their reference drugs by experts. We evaluated the adoption, costs, and savings of key biosimilars used primarily in oncology practice. Methods: We used publicly available, specialty agnostic, HCPCS level utilization and cost data from the Medicare Part B Spending by Drug dataset published by the Centers for Medicare and Medicaid Services to study the use of biosimilars for five reference drugs (Bevacizumab, Trastuzumab, Rituximab, Peg-filgrastim, Filgrastim) between 2015 and 2022. We then modeled two spending scenarios for 2022: one where only the reference drugs were used, and one where the lowest cost option (reference or biosimilar) was used for eligible indications. We calculated the savings and incremental savings opportunity to Medicare by comparing these scenarios to the actual 2022 spending. Results: Over the 8-year evaluation period, each reference drug received multiple biosimilar approvals, and biosimilar use increased from 0% to 56.4%. Lower biosimilar use of Bevacizumab may have been due to the lack of approval for ophthalmic use. The introduction of biosimilars caused price reductions for the reference drugs and the biosimilars. Biosimilar prices in 2022 were lower than their reference drugs for all except Peg-filgrastim, whose price fell below that of its biosimilars. In 2022, biosimilar adoption resulted in a 23% spending reduction for Medicare, with an additional 14% savings opportunity. Table 1 shows biosimilar adoption rates by reference drug and savings vs savings opportunity. Conclusions: The adoption of Oncology biosimilars has resulted in significant cost savings for Medicare, but there are still opportunities for further savings. The complex relationship between biosimilar prices and their utilization warrants additional evaluation. Additionally, the effects of biosimilar payment policies, such as those introduced by the Inflation Reduction Act, and the impact of payer specific product mandates on overall biosimilar adoption need to be explored further. Biosimilar adoption & 2022 spending, savings & opportunity with biosimilar adoption. Biosimilar Adoption Reference Drug 2015 2016 2017 2018 2019 2020 2021 2022 Bevacizumab - - - 0.0% 0.6% 10.5% 18.4% 22.6% Trastuzumab - - - 0.0% 2.7% 37.2% 64.2% 74.5% Rituximab - - - - 0.0% 20.5% 49.9% 59.7% Peg-filgrastim - - 0.0% 1.2% 16.9% 25.5% 34.6% 41.9% Filgrastim 0.8% 27.8% 54.6% 65.5% 72.3% 77.0% 81.5% 83.2% Total 0.2% 5.6% 10.9% 13.3% 18.5% 34.1% 49.7% 56.4% 2022 Spending, Savings and Opportunity ($ in Millions) Total Spend Savings Savings Opportunity Bevacizumab $698 $324 $60 Trastuzumab $380 $182 $111 Rituximab $1,044 $310 $276 Peg-filgrastim $628 -$37 $37 Filgrastim $37 $49 $13 Total $2,787 $827 $498