AMCP Posters Demonstrate Value of Biosimilars

Investigators had notable findings on the value of biosimilar utilization management and placement of biosimilars on formulary, in posters presented this week at the Academy of Managed Care Pharmacy (AMCP) virtual meeting: AMCP eLearning Days.

The findings also demonstrated how prophylactic biosimilars for febrile neutropenia (FN) can increase access and affordability for subsets of patients who are not encompassed by guidelines for this form of treatment.

Poster presentations also revealed a high rate of switching back to originator infliximab among patients who were stable on the originator brand and then switched to biosimilar versions.

Below is a summary of these findings, which will be discussed in more detail in stories to come.

AMCP eLearning Days continues through April 24 and extensive coverage of this conference will be provided by The Center for Biosimilars®. Return to the site often for further stories and interviews with presenters.

Savings From Use of Biosimilar Pegfilgrastim in Patients at Risk for Chemotherapy-Induced FN

Because of the high cost of treating FN, current guidelines recommend that only patients at high risk for FN be treated with a granulocyte-colony stimulating factor (G-CSF). Investigators sought to determine the potential savings from switching to biosimilar G-CSF not only for high-risk populations but also for intermediate-risk populations with nonmyeloid cancer at risk of chemotherapy-induced FN..

Converting patients from reference pegfilgrastim to biosimilar pegfilgrastim would save $92 million over 5 years, and expanding to intermediate-risk patients would save $16 million over 5 years, investigators said.

Switching Among Patients Who Achieved Stability on Originator Infliximab

Investigators found a high rate of switching back to reference infliximab among patients whose condition was stable on the originator and who were switched to a biosimilar version of the drug. The study included patients with rheumatoid arthritis, psoriatic arthritis, plaque psoriasis, ankylosing spondylitis, Crohn disease, or ulcerative colitis.

Patients who switched from the originator to the biosimilar were 2.55 times more likely to switch back to the originator biologic or to another infliximab product compared with patients who remained on originator infliximab. The mean time to switching to another biologic (including originator infliximab) was 142 days for switchers and 182 days for continuers.

Conversion to Biosimilars of Pegfilgrastim in Outpatient Settings

A retrospective study looked at the utilization rates of 2 biosimilar pegfilgrastim products before and after they were added to formulary.

Investigators examined the difference in wholesale average cost (WAC) between innovator and biosimilar products for 2 scenarios: (1) 100% total pegfilgastim conversion to biosimilars and (2) 100% pegfilgrastim syringe conversion to biosimilars.

Based on a WAC of $6231 for innovator product and $4175 for biosimilar products, the estimated annual cost savings was $3.9 million for scenario 1 and $1.6 million for scenario 2.

Results also revealed a rapid uptake for biosimilars in the outpatient setting as well as a decrease in reference product auto-injector dosages. Full savings for pegfilgrastim biosimilars most likely won’t be seen until an auto-injector dosage form is available, investigators said.

Evaluating Utilization Management Strategies on Early Adoption

Magellan Rx investigators sought to examine the effect of payer strategies for utilization of emerging biosimilars in oncology. They sought to determine if utilization management strategies, including step therapy, can improve biosimilar uptake in oncology. They found step therapy led to more approvals of biosimilars (47.6% vs 15.7%).

Use of Biosimilars Without Management Utilization in Medicare Advantage

Investigators looked at utilization of reference pegfilgrastim compared with 2 pegfilgrastim biosimilars among Medicare Advantage members over the course of a year when there was no specified utilization preference. They wanted to evaluate for missed savings opportunity.

Results showed the providers in these programs heavily favored the originator product when given a choice of the 3 options. Investigators identified a missed savings opportunity of $545,207 based on 302 claims filed for 61 unique Medicare Advantage members among a population of 32,700.

They said the originator product represented 73% (221) of total claims. Based on average wholesale price, this represented $1,652,417 in claims. If biosimilars had been used, the equivalent cost would have been $1,107,210, representing potential savings of 32%.

Future cost savings and biosimilar utilization will depend on increased access to provider education on biosimilars, federal restructuring of payment incentives, or scalable value-based agreements, investigators concluded.

To participate in AMCP eLearning Days, visit amcp.org/elearningdays.