Amgen's Anticancer Biosimilars Could Provide Substantial Hospital Budget Savings to Italian System

The International Society for Pharmacoeconomics and Outcomes Research (ISPOR) is holding its Europe 2019 meeting this week in Copenhagen, Denmark, and the savings that biosimilars can afford European healthcare systems are a hot topic at this year’s event. Two studies presented on Monday explored how Amgen’s biosimilar bevacizumab (Mvasi) and biosimilar trastuzumab (Kanjinti) could produce significant cost savings for hospitals in the Italian healthcare system.

First, a research team presented on a cost-minimization analysis of per-patient costs and potential savings that could be delivered by using the biosimilar bevacizumab instead of the reference for all indications reimbursed in Italy, which aimed to estimate the consequences of the biosimilar’s introduction over the coming 5 years.¹

Only drug costs were used, given that no differences in administration costs are expected between the reference and the biosimilar. Public drug prices were used for the reference, and a 20% discount was used for the biosimilar. Bevacizumab expenditure in Italy for 2017 was used for the budget impact analysis, and biosimilar uptake was derived from a case history of rituximab biosimilars.

The researchers report that using the biosimilar could generate savings that range from €5797 (approximately USD $6472) per patient per year when used to treat metastatic colorectal cancer to €11,595 (approximately USD $12,944) per patient per year when used to treat metastatic renal cell cancer. Over 5 years, using the biosimilar could save €145.4 million (approximately USD $162.3 million), and with increasing discounts over time, those savings numbers could grow even more.

The landscape for biosimilar trastuzumab is slightly more complex, given the fact that the originator Herceptin has a subcutaneously administered formulation available, which has the advantage of limited drug preparation time and reduced administration time.

In a cost comparison model, a second research team sought to estimate the costs from a hospital perspective for 20 patients treated with either the intravenously administered biosimilar or the subcutaneous reference product over a period of 17 cycles.²

The costs considered included drug acquisition, administration, consumables, and pharmacists’ time compensation. Public drug prices were used in the analysis.

The researchers says that, over 17 cycles, the total costs for the biosimilar were €8499 (approximately USD $9485) per patient versus €17,929 (approximately USD $20,010) per patient with the subcutaneous formulation of the reference drug. Drug costs were the primary driver of these results, at €12,012 (approximately USD $13,406) versus €21,497 (approximately USD $23,992) for the 2 products, respectively.

For the 20 patients considered together, the total cost of trastuzumab treatment with the biosimilar was €239,110 (approximately USD $266,859) versus €427,698 (approximately USD $477,332) for the reference in its subcutaneous form.

“When all relevant medical costs are considered,” say the investigators, “treatment with Kanjinti is associated with significant hospital budget savings compared to treatment with [subcutaneous Herceptin], contributing to longer-term sustainability of the healthcare spending.”

References

1. Despiégel N, Cirillo L, Gaikwad I. Cost-minimization and five-year budget impact analysis for Mvasi (bevacizumab biosimilar) in Italy. Presented at: ISPOR Europe 2019; November 2-6, 2019; Copenhagen, Denmark. Abstract PCN113.

2. D’Arpino A, Savoia M, Cirillo L, et al. Comparative cost analysis of subcutaneous trastuzumab originator (Herceptin) vs intravenous trastuzumab biosimilar (Kanjinti) from a hospital perspective in Italy. Presented at: ISPOR Europe 2019; November 2-6, 2019; Copenhagen, Denmark. Abstract PCN72.