Biosimilars offer significant savings potential while expanding patient access, particularly in oncology and immunology. | Image credit: Scott Hales – stock.adobe.com

The impact of biosimilars on healthcare costs and patient access increases, with biosimilars demonstrating significant cost savings and expanded treatment options, according to new research presented at Academy of Managed Care Pharmacy (AMCP) Nexus Conference 2024.

As of October 2024, more than 60 biosimilars have been approved by the FDAalthough a small proportion of these were approved with the interchangeability designation.¹ THE WE offers various biosimilars in the market, categorized into classes such as immunomodulators, oncology, ophthalmology, and short-acting and long-acting insulin.

Posters published as part of AMCP Nexus 2024 assessed the actual market adoption of biosimilars and their cost-effectiveness to provide broader access to all patients. AMCP Nexus took place in Las Vegas, Nevada, October 14-17, 2024.

A poster focused on increasing the use of biosimilars compared to reference products,² another poster revealed potential savings with biosimilar denosumab,³ and the final poster analyzed the cost savings of the adalimumab biosimilar, suggesting that more patients would benefit from treatment on a budget-neutral basis, which would overall improve access and fairness for patients.⁴

Real-world use of biosimilars in specialized settings

Biologics are expected to cost Medicare $32 billion a year in medical costs and $12 billion a year in pharmaceutical costs, according to the HHS Office of the Inspector General (BIG).² THE BIG predicted that Medicare members would save $179 million for medical benefits and $84 million for pharmacy benefits.

The first poster was a retrospective study evaluating the cost savings impact of biosimilars compared to reference products. The data comes from the California Specialty Pharmacies Electronic Protected Health Information System. CPR+.

The results revealed increased use of biosimilars between 2022 and 2023, with more biosimilars used after T2 2022. Biosimilars have saved all independent physician associations (IPA) approximately $22,003,938.17 over a period of 2 years. The study results may be underestimated because the price of each quarter could not be included.

Use of biosimilars in IPA in specialty pharmacy practice reveals the financial impact of biosimilars for IPAwhich can benefit patients and IPA through increased use of biosimilars. Future studies are needed to accurately determine the impacts of biosimilar products on financial savings.

Budgetary impact of biosimilar denosumab

Denosumab, a bone-modifying agent, is one of several biosimilars approved in the oncology therapeutic area and used to prevent skeletal-related events in several tumor types.³ The second poster highlighted the significant savings potential of denosumab in oncology from a Medicare perspective.

The study used a budget impact model to estimate the financial implications of Xgeva and Prolia’s oncology treatments from the perspective of a U.S. provider. The model incorporates pharmaceutical costs based on CMS limits and Medicare Part B, as well as medical costs related to government fee schedules and education.

An estimated 46,556 out of 1 million patients were treated with denosumab over a 5-year period. A 25% adoption of biosimilar denosumab by year five is expected to result in net savings of $59.1 million, or the equivalent of $1.66 per member per year (PMPY) and $0.14 per member per month (PMPM).

A 50% adoption of biosimilars could generate significant savings of $18.2 million, or $3.32. PMPYand $0.28 PMPM. Growing adoption to 70% could further amplify the savings to $31.1 million, with $5.68 and $0.47. PMPY And PMPMrespectively. A significant 90% reduction in the price of biosimilar denosumab, combined with 50% market adoption, could potentially generate $117.5 million in savings over 5 years.

Study results are subject to limitations, including the use of estimated savings, a simplified model, and assumptions regarding dosing, treatment discontinuation, and pricing.

The biosimilar denosumab has the potential to significantly reduce healthcare costs. Actual savings will depend on factors such as the final price of the biosimilar and the rate of adoption by patients and providers.

Cost-effectiveness of adalimumab biosimilars

There were 10 FDA approved adalimumab biosimilars launched since January 2023.⁴ Adalimumab is a tumor necrosis factor inhibitor used to treat patients with Crohn’s disease, plaque psoriasis, rheumatoid arthritis, and various other conditions.

The final poster aimed to estimate the cost-effectiveness and expanded access, without budget impact, to additional treatment resulting from the shift from reference to biosimilar adalimumab. The study analyzed 2 scenarios using a treatment regimen of one dose of adalimumab administered every 2 weeks for 52 weeks.

The poster compared the costs of bulk acquisition of 40 mg doses for the reference adalimumab (Humira Pen) and various biosimilars. Adalimumab-aqvh (Yusimry Pen) was the least expensive biosimilar at $292.13, although adalimumab-ryvk (Simlandi Autoinjector), the most expensive biosimilar at $1,875, was still significantly cheaper than Humira ($3,461.31).

The researchers compared the cumulative costs of biosimilar treatment and Humira per 1 and 100,000 patients. Adalimumab-aqvh (Yusimry) had the highest cost difference at week 0 ($3,169), while adalimumab-ryvk (Simlandi) had the lowest cost difference ($1,586).

Switching from Humira to any adalimumab biosimilar resulted in significant savings, allowing more patients to access treatment for 52 weeks. “This suggests the utility of biosimilar conversion and its potential to reallocate resources, thereby providing treatment to more patients on a budget-neutral basis,” the authors concluded. “Conversion improves access and equity for patients. »

References

1. Biosimilar approvals. The Biosimilars Center^®. Updated October 16, 2024. Accessed October 25, 2024. https://www.centerforbiosimilars.com/biosimilar-approvals

2. Pham A, Kiener T, Tran T, Jeong A. Real-world adoption of biosimilars among specialty pharmacy patients. Presented at: AMCP Nexus 2024; October 14-17, 2024; Las Vegas, Nevada. U39 poster.

3. Flanigan J, Chaplin S, van Stiphout J et al. Budget impact model for biosimilar denosumab in the US oncology population. Presented at: AMCP Nexus 2024; October 14-17, 2024; Las Vegas, Nevada. Poster C44.

4. Jang J, Abraham I. Modeling the cost-effectiveness and expanded access of conversion to adalimumab biosimilars from a US payer perspective. Presented at: AMCP Nexus 2024; October 14-17, 2024; Las Vegas, Nevada. Poster U42.