Research Demonstrates Biosimilars' Increasing Role in Cancer Treatment

During this week’s International Society for Pharmacoeconomics and Outcomes Research 2018 European meeting, the role of biosimilars in oncology is the subject of several research presentations, all of which underscore the importance of these agents in increasing patient access and driving down costs.

CT-P6 Could Allow for Thousands More to Be Treated

First, researchers presented findings on the budget impact of introducing CT-P6 (Herzuma), a biosimilar trastuzumab, in 28 European nations.¹ The budget impact model analyzed substitution of CT-P6 for the originator Herceptin in treating early breast cancer, metastatic breast cancer, and metastatic gastric cancer with a time horizon ranging from 1 to 3 years.

The base case analysis assumed that the price of CT-P6 was 30% lower than that of the originator, that the substitution rate of the biosimilar was 20% in the first year, and that substitution would grow by 5% each year.

In analyses using the base case scenario over 3 years, the researchers found that the total savings generated ranged from €290 million to €562 million ($327 million to $633 million). With these savings, they wrote, the number of additional patients who could be treated with trastuzumab ranged from 27,145 to 44,810.

In the first year alone, Europe could save €53 million to €272 million ($60 million to $306 million), and the number of additional patients who could be treated from these savings during the first year was 4982 to 21,730.

Oncologists Lead the Way in Adopting Biosimilar Rituximab

Other research demonstrates that European oncologists are adopting biosimilars more quickly than are specialist in other disciplines.²

Using a multi-country, multi-center medical chart review, researchers assessed 123 oncologists and 332 rheumatologists who were involved in prescribing rituximab for their patients. For the period between January and March 2018, 48% of oncologists reported treating a patient with biosimilar rituximab, while only 7% of rheumatologists reported doing so. Between July and September 2017, these figures were 14% and 4%, respectively, demonstrating a rapid increase in biosimilar uptake among oncologists.

Furthermore, a greater number of oncologists switched patients to the biosimilar; the incidence of nonmedical switching to the biosimilar rituximab in second-line treatment for non-Hodgkin lymphoma was 95%, while the incidence of switching to the biosimilar in second-line treatment for rheumatoid arthritis was 31%.

Among oncologists, the top reasons for using the biosimilar were that it was the approved standard of care, had proven efficacy, and was on formulary. Further investigation into the differences in uptake among specialties, wrote the authors, is warranted.

Serbian Experience Shows the Need for Biosimilars

Finally, research from Serbia underscores the critical need for biosimilars in oncology.³ A study by authors from the Military Medical Academy in Belgrade found that for patients with metastatic colorectal cancer (mCRC), treatment with bevacizumab, cetuximab, and panitumumab provides additional benefits versus first-line cytotoxic treatment.

Bevacizumab and cetuximab are reimbursed in Serbia—though no novel third-line biologics are available or reimbursed in the Serbian system—and while patients who are treated with monoclonal antibodies had 6-month longer overall survival, these drugs are associated with an ICER that is 3 times higher than the informal willingness-to-pay threshold in Serbia.

Costs will be significantly decreased upon biosimilar entry for bevacizumab, but the European patent on the originator (Avastin) will not expire before 2022. Once the biosimilars become available, say the authors, significant savings could allow for more affordable treatment for patients with mCRC.

References

1. Suh D, Lee S, Suh D. Budget impact of substituting biosimilar trastuzumab (CT-P6) in treating gastric cancer and breast cancer in 28 European countries. Presented at the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Europe 2018, November 10-14, 2018; Barcelona, Spain. Abstract PCN69. https://tools.ispor.org/ScientificPresentationsDatabase/Presentation/87592?pdfid=58499.

2. Franceschetti A, Baskett A, Baynton E, Baldock D, Karki C. Comparative analysis of biosimilar rituximab usage in treating non-Hodgkin lymphoma and rheumatoid arthritis: results from a multi-country study in Europe. Presented at the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Europe 2018, November 10-14, 2018; Barcelona, Spain. Abstract PHP113. https://tools.ispor.org/ScientificPresentationsDatabase/Presentation/88596?pdfid=57492.

3. Kovačević A, Dragojević-Simić V. Availability and affordability of novel biological therapy in Serbia for patients with metastatic colorectal cancer. Presented at the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Europe 2018, November 10-14, 2018; Barcelona, Spain. Abstract PCN114. https://tools.ispor.org/ScientificPresentationsDatabase/Presentation/88792?pdfid=58371.