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Heng JE, Raman S, Wong ZY, Beh VJN. Cost minimization analysis of subcutaneous trastuzumab versus intravenous biosimilar trastuzumab: policy recommendations for breast cancer treatment in Malaysia. Daru 2024; 32:67-76. [PMID: 37903943 PMCID: PMC11087381 DOI: 10.1007/s40199-023-00485-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 09/29/2023] [Indexed: 11/01/2023] Open
Abstract
PURPOSE Current clinical practice recommends switching innovator intravenous trastuzumab (IV-TZMi) to subcutaneous trastuzumab (SC-TZM) to save healthcare resources. However, with the availability of biosimilar intravenous trastuzumab (IV-TZMb), there is a need to re-evaluate the recommendation. Hence, this study aims to compare the cost and resource use of SC-TZM and IV-TZMb in a Malaysian public healthcare facility. METHODS This activity-based costing study consists of (1) a retrospective medical record abstraction to determine patient details to estimate drug costs and (2) a time-motion study to quantify personnel time, patient time, and consumables used. The total cost of both SC-TZM and IV-TZMb were then compared using a cost-minimization approach, while differences were explored using an independent t-test. A sensitivity analysis was also conducted to determine the impact of uncertainties in the analysis. RESULTS The mean total cost of SC-TZM and IV-TZMb was USD 13,693 and USD 5,624 per patient respectively. The cost difference was primarily contributed by savings in drug cost of IV-TZMb, a reduction of USD 8,546 (SD = 134), p < 0.001 compared to SC-TZM. Interestingly, SC-TZM had a significantly lower cost than IV-TZMb for both the consumable and personnel cost, a reduction by USD 300 (SD = 17.6); p < 0.001 and USD 176 (SD = 7.3); p < 0.001 respectively. The sensitivity analysis demonstrated that the total cost difference between the formulation was mainly driven by drug costs. CONCLUSION The study evidenced that IV-TZMb was a more economically viable option in Malaysian public healthcare currently compared to SC-TZM.
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Affiliation(s)
- Jin Ee Heng
- Pharmacy Department, Penang General Hospital, Ministry of Health Malaysia, Penang, Malaysia.
| | - Sivaraj Raman
- Centre for Health Economics Research, Institute for Health Systems Research, National Institutes of Health, Shah Alam, Malaysia
| | - Zhi Yen Wong
- Pharmacy Department, Penang General Hospital, Ministry of Health Malaysia, Penang, Malaysia
| | - Valerine Jen Nin Beh
- Pharmacy Department, Penang General Hospital, Ministry of Health Malaysia, Penang, Malaysia
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Coakley KE, Bambury RM, McGuinness E, Dennehy M, Ronayne C, Cahill M, O'Reilly S. An evaluation of the utilisation of biosimilar monoclonal antibody drugs in Ireland and barriers to their usage. Ir J Med Sci 2024; 193:1191-1199. [PMID: 38194005 DOI: 10.1007/s11845-023-03587-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 12/05/2023] [Indexed: 01/10/2024]
Abstract
BACKGROUND While biologic drugs have demonstrated efficacy across a range of indications, patient access to these drugs is constrained due to their high cost. Biosimilars provide a means to increase patient access while reducing the financial burden. AIMS The primary objective was to determine the current usage of biosimilar and reference trastuzumab and rituximab in four Irish hospitals. A secondary objective involved determining barriers to biosimilar usage. METHODS This project involved a retrospective chart review to analyse the usage of reference and biosimilar versions of trastuzumab and rituximab. Additionally, a prospective cross-sectional study identified barriers to the usage of biosimilars via the distribution of a novel questionnaire to patients, pharmacists, doctors and students. RESULTS The utilisation of biosimilar intravenous trastuzumab and rituximab ranged from 39 to 100%, and 0 to 89%, respectively. A total of n = 479 questionnaire responses were included. Biosimilar awareness was significantly lower among 'Doctors and Medical Students' (45.3%; 95% [CI, 33.8-57.3%]) compared to 'Pharmacists and Pharmacy Students' (97.1%; 95% [CI, 94-98.8%; comparison p < 0.001]). A significant majority of healthcare professionals agreed biosimilars should have consistent nomenclature (p < 0.001). A significant majority of patients (87.3%, 95% [CI, 81.3-92%; p < 0.001]) indicated that they would agree to commence using a biosimilar medicine. CONCLUSION Biosimilar versions of trastuzumab and rituximab were in use to a variable extent. There remains a considerable opportunity to further increase the usage to maximise their potential benefits. A series of challenges were identified including reduced awareness among the medical profession and lack of clear nomenclature.
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Affiliation(s)
| | - Richard M Bambury
- Cancer Research @UCC, University College Cork and Department of Medical Oncology, Cork University Hospital, Wilton, Cork, Ireland
| | - Eimear McGuinness
- Pharmacy Department, South Infirmary Victoria University Hospital, Old Blackrock Road, Ballintemple, Cork, Ireland
| | - Maeve Dennehy
- Pharmacy Department, Mercy University Hospital, Grenville Place, Cork, Ireland
| | - Cian Ronayne
- Pharmacy Department, Cork University Hospital, Wilton, Cork, Ireland
| | - Mary Cahill
- Haematology Department, Cork University Hospital, Wilton, Cork, Ireland
| | - Séamus O'Reilly
- Cancer Research @UCC, University College Cork and Department of Medical Oncology, Cork University Hospital, Wilton, Cork, Ireland
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Park MH, Seo JH, Park JH, Seong MK, Park KU, Kim MK, Chang M, Koh SJ, Lee MH, Lim ST, Yoo YB, Oh SY, Kim SH, Ahn KY, Park TH, Ju H, Baek EH, Kim S, Kim N, Lee E, Kim TH. Efficacy and safety of biosimilar trastuzumab (CT-P6) in routine clinical practice in the Republic of Korea: a real-world post-marketing surveillance study. Expert Opin Biol Ther 2024; 24:305-312. [PMID: 38664937 DOI: 10.1080/14712598.2024.2334386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 03/20/2024] [Indexed: 04/30/2024]
Abstract
BACKGROUND The trastuzumab biosimilar CT-P6 is approved for human epidermal growth factor receptor 2 (HER2)-positive early breast cancer (EBC), metastatic breast cancer (MBC), and metastatic gastric cancer (MGC). The objective of this post-marketing surveillance (PMS) study was to evaluate the real-world safety and effectiveness of CT-P6 in patients with HER2-positive cancers. RESEARCH DESIGN AND METHODS This open-label, observational, prospective, PMS study collected data via investigator surveys from 35 centers in the Republic of Korea (5 October 2018-4 October 2022). Eligible patients with HER2-positive EBC, MBC, or MGC started CT-P6 treatment during routine clinical practice, followed by 1-year observation. Evaluations included adverse events (AEs), adverse drug reactions (ADRs), and effectiveness. RESULTS Safety was analyzed in 642 patients (494 EBC, 94 MBC, 54 MGC). Overall, 325 (50.6%) patients experienced 1316 AEs, and 550 ADRs occurred in 199 (31.0%) patients. Unexpected ADRs occurred in 62 (9.7%) patients. Unexpected ADRs and ADRs of special interest did not raise any new safety signals. Among trastuzumab-naïve patients, 34/106 (32.1%) with EBC achieved pathological complete response; 30/74 (40.5%) MBC and 24/49 (49.0%) MGC patients achieved complete or partial response. CONCLUSIONS In a real-world setting, CT-P6 demonstrated safety and efficacy findings consistent with previous CT-P6 studies.
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Affiliation(s)
- Min Ho Park
- Chonnam National University Medical School and Hwasun Hospital, Hwasun, Republic of Korea
| | - Jae Hong Seo
- Korea University Guro Hospital, Seoul, Republic of Korea
| | - Jung Ho Park
- Hallym University Sacred Heart Hospital, Anyang, Republic of Korea
| | - Min-Ki Seong
- Korea Cancer Center Hospital, Seoul, Republic of Korea
| | - Keon Uk Park
- Keimyung University Dongsan Medical Hospital, Daegu, Republic of Korea
| | - Min Kyoon Kim
- Chung-Ang University Hospital, Seoul, Republic of Korea
| | | | - Su-Jin Koh
- Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Moon Hee Lee
- Inha University Hospital, Incheon, Republic of Korea
| | - Seung Taek Lim
- Wonju Severance Christian Hospital, Wonju, Republic of Korea
| | - Young Bum Yoo
- Konkuk University Medical Center, Seoul, Republic of Korea
| | - So Yeon Oh
- Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | | | | | | | - Hana Ju
- Celltrion, Inc., Incheon, Republic of Korea
| | | | - Sinhye Kim
- Celltrion, Inc., Incheon, Republic of Korea
| | - Nahyun Kim
- Celltrion, Inc., Incheon, Republic of Korea
| | | | - Tae Hyun Kim
- Inje University, Busan Paik Hospital, Busan, Republic of Korea
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Barat EC, Arrii MLE, Soubieux-Bourbon A, Daouphars M, Varin R, Tilleul PR. Cost effectiveness of using trastuzumab biosimilars compared to trastuzumab original drugs to treat breast cancer in a hospital setting. Breast 2023; 72:103588. [PMID: 37857129 PMCID: PMC10587754 DOI: 10.1016/j.breast.2023.103588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 10/04/2023] [Accepted: 10/06/2023] [Indexed: 10/21/2023] Open
Abstract
INTRODUCTION Subcutaneous (SC) drug administration, such as the Herceptin® in an oncology day hospital reduces the administration time of trastuzumab. In the context of combination therapy administration, this time-saving may be called into question. The challenge posed by the deployment of much less expensive IV biosimilar forms raises questions about the cost-effectiveness of SC administration. METHODS Using data from a french Diagnostic Related Groups regarding prescriptions of intravenous Herceptin® (HIV), Herceptin® biosimilar IV (BSIV), and Herceptin® subcutaneous (HSC), we conducted two simulations. This simulation involved replacing all HSC with BSIV in combination therapy administration (Simulation 1) and subsequently substituting IV forms with SC forms only when prescribed as monotherapy (Simulation 2). A cost-benefit analysis was conducted based on these two simulations, from the hospital's perspective, for Normandy's population over a 1-year timeframe. RESULTS In Simulation 1, there was an average cost-saving of €12 per patient per year, but it resulted in a loss of 10140 min, equivalent to 10 min per patient per year when compared to the current situation. Simulation 2 yielded average cost-savings for the hospital amounting to €51 per patient per year, along with a time-saving of 67 min per patient per year compared to the current situation. CONCLUSIONS The development of a program aimed at optimizing the prescription of Trastuzumab holds the potential to deliver significant cost-savings to hospitals while enhancing the quality of service provided to the patients. This optimization involves using H SC in monotherapy and BS IV in combination therapy administration.
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Affiliation(s)
- Eric C Barat
- Department of Pharmacy, CHU Rouen, Normandie University, UNICAEN, Inserm, U1086, Caen, France.
| | | | | | - Mikaël Daouphars
- Department of Pharmacy, Henri Becquerel Cancer Center, 76038, Rouen, France
| | - Rémi Varin
- Department of Pharmacy, UNIROUEN, Inserm, U1234, CHU Rouen, Normandie University, Rouen, France
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Abdelmeseh V, Brown BR, Huynh JP, Zullo AR. Comparative cost savings of biosimilar and dose rounding utilization in oncology care. J Oncol Pharm Pract 2023; 29:1437-1442. [PMID: 36259235 PMCID: PMC10113396 DOI: 10.1177/10781552221134257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The exponential rise in cancer costs has led many centers to utilize dose rounding to the nearest vial size when the difference in dose is ≤10% to decrease costs. The recent approval of several biosimilar products has presented another opportunity to mitigate the rising costs of oncology care. Scarce information exists about the expected cost savings of combining dose rounding strategies (DRS) with biosimilar use (BU). We therefore assessed the cost savings of combining DRS and BU. METHODS Electronic health record data for two health systems in Rhode Island were used to identify patients who received ≥1 of trastuzumab, trastuzumab-anns, bevacizumab, or bevacizumab-awwb from October 1, 2015 to September 1, 2020. Costs were estimated using Medicare drug pricing. Multivariable generalized estimating equations adjusting for age, gender, presence of metastases, dosing weight, and dose administered were used to compare costs per dose between the four exposure groups: DRS + BU, DRS only, BU only, and neither DRS or BU. RESULTS A total of 1156 patients were administered 15,145 doses of drug. After covariate adjustment, average savings per dose was greatest in the DRS + BU group (vs. the neither DRS nor BU group); $331 for trastuzumab and $497 for bevacizumab. CONCLUSIONS Combining dose rounding with biosimilar substitution for trastuzumab and bevacizumab resulted in significant cost savings per dose and should be implemented by healthcare systems.
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Affiliation(s)
- Verona Abdelmeseh
- Department of Pharmacy, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Department of Pharmacy, Lifespan—Rhode Island Hospital, Providence, RI, USA
- Department of Pharmacy and Health Sciences, University of Rhode Island, Kingston, RI, USA
| | - Britny R Brown
- Department of Pharmacy and Health Sciences, University of Rhode Island, Kingston, RI, USA
- Department of Pharmacy, Care New England—Women and Infants Hospital, Providence, RI, USA
| | - Justin P Huynh
- Department of Pharmacy, Lifespan—Rhode Island Hospital, Providence, RI, USA
- Department of Pharmacy and Health Sciences, University of Rhode Island, Kingston, RI, USA
| | - Andrew R Zullo
- Department of Pharmacy, Lifespan—Rhode Island Hospital, Providence, RI, USA
- Departments of Health Services, Policy, and Practice and Epidemiology, Brown University School of Public Health, Providence, RI, USA
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Stebbing J, Baranau Y, Baryash V, Moiseyenko V, Boliukh D, Antone N, Manikhas A, Chornobai A, Park T, Baek EH, Lee J, Choi J, Kim N, Ahn K, Lee SJ, Kim S. Six-Year Survival Outcomes for Patients with HER2-Positive Early Breast Cancer Treated with CT-P6 or Reference Trastuzumab: Observational Follow-Up Study of a Phase 3 Randomised Controlled Trial. BioDrugs 2023; 37:433-440. [PMID: 36881323 DOI: 10.1007/s40259-023-00582-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2023] [Indexed: 03/08/2023]
Abstract
BACKGROUND The Phase 3 CT-P6 3.2 study demonstrated equivalent efficacy and comparable safety between CT-P6 and reference trastuzumab in patients with human epidermal growth factor receptor-2 (HER2)-positive early breast cancer after up to 3 years' follow-up. OBJECTIVE To investigate long-term survival with CT-P6 and reference trastuzumab. METHODS In the CT-P6 3.2 study, patients with HER2-positive early breast cancer were randomised to neoadjuvant chemotherapy with CT-P6 or reference trastuzumab, surgery, and adjuvant CT-P6 or reference trastuzumab before a 3-year post-treatment follow-up. Patients who completed the study could enter a 3-year extension (CT-P6 4.2 study). Data were collected every 6 months to assess overall survival (OS), disease-free survival (DFS), and progression-free survival (PFS). RESULTS Of 549 patients enrolled in the CT-P6 3.2 study, 216 (39.3%) patients continued in the CT-P6 4.2 study (CT-P6, 107; reference trastuzumab, 109) (intention-to-treat extension set). Median follow-up was 76.4 months for both groups. Medians were not reached for time-to-event parameters; estimated hazard ratios (95% confidence intervals) for CT-P6 versus reference trastuzumab were 0.59 (0.17-2.02) for OS, 1.07 (0.50-2.32) for DFS, and 1.08 (0.50-2.34) for PFS. Corresponding 6-year survival rates in the CT-P6 and reference trastuzumab groups, respectively, were 0.96 (0.90-0.99) and 0.94 (0.87-0.97), 0.87 (0.78-0.92) and 0.89 (0.81-0.94), and 0.87 (0.78-0.92) and 0.89 (0.82-0.94). CONCLUSIONS Data from this extended follow-up of the CT-P6 3.2 study demonstrate the comparable long-term efficacy of CT-P6 and reference trastuzumab up to 6 years. EUDRACT NUMBER 2019-003518-15 (retrospectively registered 10 March 2020).
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Affiliation(s)
- Justin Stebbing
- Department of Surgery and Cancer, Imperial College London, London, UK.,School of Life Sciences, Anglia Ruskin University, Cambridge, UK.,Oncogene, London, UK
| | - Yauheni Baranau
- Chemotherapy Department 1, Minsk City Clinical Cancer Center, Minsk, Belarus
| | - Valery Baryash
- Chemotherapy Department 1, Minsk City Clinical Cancer Center, Minsk, Belarus
| | - Vladimir Moiseyenko
- Oncology Department, St. Petersburg Clinical Scientific and Practical Centre of Specialized Kinds of Medical Care, St. Petersburg, Russian Federation
| | - Dmytro Boliukh
- Chemotherapy Department, Vinnytsya Regional Clinical Oncology Dispensary, Vinnytsya, Ukraine
| | - Nicoleta Antone
- Radiotherapy I Department, IOCN-The Oncology Institute "Prof. Dr. Ion Chiricuta", Cluj-Napoca, Romania
| | - Alexey Manikhas
- Oncology Department, City Clinical Oncological Dispensary, St. Petersburg, Russian Federation
| | - Anatolii Chornobai
- Chemotherapy Department, Poltava Regional Clinical Oncology Center, Poltava, Ukraine
| | - Taehong Park
- Clinical Planning, Celltrion, Inc., Incheon, Republic of Korea
| | | | - Jaeyong Lee
- Biometrics, Celltrion, Inc., Incheon, Republic of Korea
| | - Jiin Choi
- Biometrics, Celltrion, Inc., Incheon, Republic of Korea
| | - Nahyun Kim
- Biometrics, Celltrion, Inc., Incheon, Republic of Korea
| | - Keumyoung Ahn
- Clinical Planning, Celltrion, Inc., Incheon, Republic of Korea
| | - Sang Joon Lee
- Data Science Institute, Celltrion, Inc., Incheon, Republic of Korea
| | - Sunghyun Kim
- Medical Science Division, Celltrion, Inc., 23, Academy-ro, Yeonsu-gu, Incheon, 22014, Republic of Korea.
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Lengyel CG, Habeeb BS, Altuna SC, Trapani D, Khan SZ, Hussain S. The Global Landscape on the Access to Cancer Medicines for Breast Cancer: The ONCOLLEGE Experience. Cancer Treat Res 2023; 188:353-368. [PMID: 38175353 DOI: 10.1007/978-3-031-33602-7_14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
There is a growing global debate over barriers affecting the timely access to innovative anticancer therapies. Access to medicines is often traced back to the issue of costs: however, more commonly, the distance between valuable innovative treatments and the actual treatment of patients is far beyond the mere problem of financial barriers. A comprehensive approach to understand, assess to medicines should be pursued, to dissect the determinants and formulate solutions for all patients. In this chapter, we discuss drivers of access to innovation for patients with breast cancer, based on a case study of access to HER2-diagnositcs and therapeutics yielding a global landscape analysis, based on the efforts and expertise of the global collaborative group "ONCOLLEGE".
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Affiliation(s)
| | - Baker Shalal Habeeb
- Department of Medical Oncology, Shaqlawa Teaching Hospital, Shaqlawa, Erbil, 44005, Iraq
| | | | - Dario Trapani
- Department of Oncology and Hematology, University of Milan, 20122, Milan, Italy
| | - Shah Zeb Khan
- Department of Clinical Oncology, Bannu Institute of Nuclear Medicine Oncology and Radiotherapy (BINOR), Bannu, Khyber Pakhtunkhwa, Pakistan
| | - Sadaqat Hussain
- Leicester Royal Infirmary, University Hospitals of Leicester, Leicester, LE1 5WW, UK
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Mohammadnezhad G, Sattarpour M, Moradi N. Budget impact analysis of breast cancer medications: a systematic review. J Pharm Policy Pract 2022; 15:105. [PMID: 36581921 PMCID: PMC9801587 DOI: 10.1186/s40545-022-00493-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 11/15/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Breast cancer (BC) is the most common cancer globally among women, with 2,261,419 new cases in 2020; systemic treatment may be neo-adjuvant, adjuvant, or both. BC subtype guides the standard systemic therapy administered, which consists of endocrine therapy for all HR + tumors, trastuzumab-based HER2-directed antibody therapy plus chemotherapy for all HER2 + tumors (with endocrine therapy given in addition, if concurrent HR positivity), and chemotherapy alone for the triple-negative subtype. This study aimed to identify, evaluate, and systematically review all budget impact analyses (BIAs) of BC medications worldwide. METHODS PubMed, Scopus, and Web of Science Core Collection databases were thoroughly searched up to 26th March 2022 to identify original published studies which evaluate BIA of BC medications. ISPOR Task Force guidelines were used to assess the quality of included studies. This study was conducted and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS In total, 17 BIAs were included in the study. About half of the studies were conducted in Europe. The results of the BIAs showed that most of the included BIAs are conducted from the payer's perspective; they have different methodological frameworks for recommended chemotherapy, targeted therapy, and immunotherapy agents to treat BC. For the same medications, the results of budgetary effects are not consistent in diverse countries. Nine out of the 17 studies were focused on trastuzumab, in which the biosimilar form reduced costs, but the brand form increased costs, especially in a 52-week treatment period. CONCLUSION Researchers should conduct the budget impact analysis of high-value medications such as anti-tumor drugs more objectively, and the accuracy of parameters needs to be more strictly guaranteed. Furthermore, it is worthy of declaring that the budgetary impact of the same drug is not always consistent over time, so the researchers should measure access to medication in the long run.
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Affiliation(s)
- Ghader Mohammadnezhad
- grid.411600.2School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Melika Sattarpour
- grid.411600.2School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Najmeh Moradi
- grid.411746.10000 0004 4911 7066Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran
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Deng W, Hu J, Li M, Yang S, Xie Z, Chen J. Trastuzumab biosimilar HLX02 versus reference trastuzumab in patients with recurrent or metastatic HER2-positive breast cancer: a model-based economic evaluation for China. Expert Rev Pharmacoecon Outcomes Res 2022; 22:1117-1126. [PMID: 35899310 DOI: 10.1080/14737167.2022.2107506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 05/22/2022] [Accepted: 07/26/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND HLX02 is a newly marketed trastuzumab biosimilar in China, but whether its price reflects a potential benefit in terms of its value remains unclear. In addition, the development of biosimilars in China is just beginning, and the state encourages health economic evaluation of newly marketed biosimilars. METHODS Based on the previously published randomized controlled trial data, a Markov model was used to perform health economic evaluation of HLX02 and trastuzumab in the treatment of HER2-positive recurrent or metastatic breast cancer, calculate quality-adjusted life years (QALYs) and incremental cost-effectiveness ratio (ICER), and evaluate the robustness of the model with sensitivity analysis. RESULTS The model results showed that the 5-year mortality rate was 84.4% in the HLX02 group, while the mortality rate was 91.2% in the trastuzumab group. When without accounting for the cost of second-line treatment, patients treated with HLX02 had an increased life expectancy of 0.138 QALYs and a $421.11 lower cost compared with patients in the trastuzumab group, with an ICER value of -$3,051.52/QALY. CONCLUSIONS At the willingness-to-pay threshold of $37,653/QALY in China, HLX02 is more cost-effective than trastuzumab. However, the relevant systems for the regulation of biosimilars still need to be improved.
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Affiliation(s)
- Weishang Deng
- Key Specialty of Clinical Pharmacy, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, Guangdong, China
| | - Jia Hu
- Key Specialty of Clinical Pharmacy, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, Guangdong, China
| | - Mengting Li
- Key Specialty of Clinical Pharmacy, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, Guangdong, China
| | - Sensen Yang
- Key Specialty of Clinical Pharmacy, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, Guangdong, China
| | - Zeyu Xie
- Key Specialty of Clinical Pharmacy, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, Guangdong, China
| | - Jisheng Chen
- Key Specialty of Clinical Pharmacy, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, Guangdong, China
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Budget Impact Analysis of the Introduction of a Trastuzumab Biosimilar for HER2-Positive Breast Cancer in China. Clin Drug Investig 2022; 42:937-947. [DOI: 10.1007/s40261-022-01197-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2022] [Indexed: 11/25/2022]
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Systematic Review on the Use of Biosimilars of Trastuzumab in HER2+ Breast Cancer. Biomedicines 2022; 10:biomedicines10082045. [PMID: 36009592 PMCID: PMC9405693 DOI: 10.3390/biomedicines10082045] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 08/11/2022] [Accepted: 08/18/2022] [Indexed: 11/17/2022] Open
Abstract
Trastuzumab is a monoclonal antibody used in the treatment of breast cancer in cases where the tumor overexpresses the HER2 receptor, a cell membrane receptor activated by the epidermal growth factor. Intravenous and subcutaneous administration of trastuzumab have comparable clinical and pharmacological characteristics, but trastuzumab biosimilars are currently only available in intravenous form. Trastuzumab biosimilars are ultimately preferred by a proportion of patients, especially in cases where co-administration of other chemotherapeutic agents, such as trastuzumab and tucatinib, a small molecule of tyrosine kinase inhibitor, is required in patients with HER-positive metastatic breast cancer. Oncologists should be well-aware of the advantages of intravenously administered trastuzumab biosimilars over subcutaneous administration, certainly also taking into account the patient’s preferences. Further cost-effectiveness analyses will be very important, along with expectations regarding successful concomitant subcutaneous administration of trastuzumab with other anticancer drugs, such as pertuzumab. This systematic review describes and analyzes the so-far published studies concerning the use of the available trastuzumab biosimilars in HER-positive early and metastatic breast cancer in terms of efficacy, safety, and cost–benefit ratio. An attempt was also made to draw some conclusions and to comment on future needs and perspectives.
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A Review of Trastuzumab Biosimilars in Early Breast Cancer and Real World Outcomes of Neoadjuvant MYL-1401O versus Reference Trastuzumab. Curr Oncol 2022; 29:4224-4234. [PMID: 35735446 PMCID: PMC9221768 DOI: 10.3390/curroncol29060337] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 06/08/2022] [Accepted: 06/10/2022] [Indexed: 11/16/2022] Open
Abstract
The reduced cost of trastuzumab biosimilars has led to increased adoption for HER2-positive breast cancer. This review of trastuzumab biosimilars encompasses this development and real world clinical data in early breast cancer. In addition, we present a retrospective study evaluating the total pathological complete response (tpCR) rates (lack of residual invasive cancer in resected breast tissue and axillary nodes), of MYL-1401O to reference trastuzumab (TRZ) in the neoadjuvant setting for HER2+ early breast cancer (EBC) in Alberta, Canada. Neoadjuvant patients with HER2+ EBC treated with TRZ from November 2018–October 2019 and MYL-1401O from December 2019–September 2020 were identified. Logistic regression was used to control for variables potentially associated with tpCR: trastuzumab product, age, pre-operative T- and N-stage, grade, hormone receptor (HR)-status, HER2-status, chemotherapy regimen, and chemotherapy completion. tpCR was 35.6% in the MYL-1401O group (n = 59) and 40.3% in the TRZ (n = 77) group, p = 0.598. After controlling for clinically relevant variables, there was no significant difference in the odds of achieving tpCR in patients treated with TRZ versus MYL-1401O (OR 1.1, 95% CI 0.5–2.4, p = 0.850). tpCR rates were similar for patients treated with MYL-1401O compared to trastuzumab in our real world study of HER2+ neoadjuvant EBC and comparable to pivotal phase 3 trials.
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Hariprasad SM, Gale RP, Weng CY, Ebbers HC, Rezk MF, Tadayoni R. An Introduction to Biosimilars for the Treatment of Retinal Diseases: A Narrative Review. Ophthalmol Ther 2022; 11:959-982. [PMID: 35278204 PMCID: PMC9114261 DOI: 10.1007/s40123-022-00488-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 02/16/2022] [Indexed: 12/03/2022] Open
Abstract
Biological therapies have revolutionized the treatment of disease across a number of therapeutic areas including retinal diseases. However, on occasion, such treatments may be relatively more expensive compared to small molecule therapies. This can restrict patient access and treatment length leading to suboptimal clinical outcomes. Several biosimilar candidates of ranibizumab and aflibercept are currently in development and the first biosimilar of ranibizumab received EMA approval in August and FDA approval in September 2021. Biosimilars are biological medicines that are highly similar to an already-approved biological medicine (reference product). The physicochemical and clinical similarity of a biosimilar is determined by a rigorous analytical and clinical program, including extensive pharmacokinetic and pharmacodynamic analysis with phase III equivalence studies where appropriate. These phase III studies are carried out in a patient population that is representative of all of the potential approved therapeutic indications of the originator product and the most sensitive for detecting potential differences between the biosimilar and the reference product. Biosimilars have been used successfully across a wide range of therapeutic areas for the past 15 years where they have achieved substantial cost savings that can be reinvested into healthcare systems without affecting the quality of patient care. The current review provides an introduction to biosimilars with the aim of preparing retinal specialists for discussing these products with their patients.
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Affiliation(s)
- Seenu M Hariprasad
- Department of Ophthalmology and Visual Science, University of Chicago Medicine, Chicago, IL, USA.
| | - Richard P Gale
- Department of Ophthalmology, York Teaching Hospital, University of York, York, UK
| | - Christina Y Weng
- Department of Ophthalmology, Cullen Eye Institute, Baylor College of Medicine, Houston, TX, USA
| | | | | | - Ramin Tadayoni
- Université de Paris, AP-HP, Lariboisière, Saint Louis and Fondation Adolphe de Rothschild Hospitals, Paris, France
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Peliçário Vargas B, Sari MHM, Ferreira LM. Trastuzumab in breast cancer treatment: the Era of biosimilars. Anticancer Agents Med Chem 2022; 22:2507-2516. [PMID: 35236272 DOI: 10.2174/1871520622666220302114313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 11/24/2021] [Accepted: 12/19/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND The discovery of trastuzumab as anti-HER2 therapy markedly improved disease control and the survival rates of patients with HER2+ breast cancer. However, as trastuzumab is considered a complex molecule, the cost of production is usually elevated, which significantly affects health budgets and limits the treatment access for patients who live in underdeveloped countries. Recently, trastuzumab production became more accessible and sustainable due to the patents' expiration, allowing biosimilar versions of trastuzumab to be developed. OBJECTIVE Our main goal was to shed more light on the uses of biosimilars in breast cancer treatment, emphasizing trastuzumab. METHOD An integrative review was carried out in the PubMed, Scielo, Web of Science, and SCOPUS databases using the terms "biosimilar," "breast cancer," "monoclonal antibody," and "trastuzumab." The time range included scientific articles published from 2015 to 2021. RESULTS AND DISCUSSION The bibliographic survey showed the complexities in biological medicine manufacturing and how the monoclonal antibody's therapy with trastuzumab improved the patients' life expectancy, revolutionizing HER2+ breast cancer treatment. Nonetheless, despite its benefits, trastuzumab generates certain restrictions, especially from the economic perspective. Trastuzumab biosimilars have high selectivity and rarely cause adverse effects compared to conventional chemotherapy. CONCLUSION This study shows that trastuzumab biosimilars improve patients' accessibility to breast cancer treatment through a safe and effective therapy compared to the drug reference.
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Affiliation(s)
- Bárbara Peliçário Vargas
- Departamento de Farmácia Industrial, Curso de Farmácia, Centro de Ciências da Saúde, Universidade Federal de Santa Maria, Santa Maria, Brazil
| | | | - Luana Mota Ferreira
- Departamento de Farmácia Industrial, Curso de Farmácia, Centro de Ciências da Saúde, Universidade Federal de Santa Maria, Santa Maria, Brazil;
- Programa de Pós-graduação em Ciências Farmacêuticas, Centro de Ciências da Saúde, Universidade Federal de Santa Maria, Santa Maria, Brazil
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Alghamdi A, Balkhi B, Alqahtani S, Almotairi H. The Economic Burden Associated with the Management of Different Stages of Breast Cancer: A Retrospective Cost of Illness Analysis in Saudi Arabia. Healthcare (Basel) 2021; 9:907. [PMID: 34356285 PMCID: PMC8307453 DOI: 10.3390/healthcare9070907] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 07/15/2021] [Accepted: 07/16/2021] [Indexed: 01/04/2023] Open
Abstract
Globally, breast cancer management is associated with a heavy economic burden, but its impact in Saudi Arabia has not been fully quantified. The aim of this study was to estimate the economic burden of breast cancer management at various disease stages, in Saudi Arabia, from a payer perspective. We conducted a retrospective, multicenter cost of illness study in two governmental healthcare centers from January to December 2018, using the data of 300 patients at different breast cancer stages. A micro-costing, bottom-up method was used, and descriptive and inferential statistics were analyzed. The total estimated cost for treating breast cancer during the study period was $13.345 million USD, with the average cost per patient ranging from $14,249 USD in stage I to $81,489 USD in stage IV (p < 0.001). Medication cost was the main driver of total healthcare spending, followed by hospitalization and diagnostic tests. The cost of targeted therapy drugs represented 67% of the total medication costs, mostly driven by trastuzumab-based regimens. The economic burden of breast cancer management in Saudi Arabia is substantial and increases significantly with disease advancement. Early detection screening programs, evaluating the value of highly expensive interventions, and considering biosimilars, may contribute toward cost savings.
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Affiliation(s)
- Ahmed Alghamdi
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia; (B.B.); (H.A.)
| | - Bander Balkhi
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia; (B.B.); (H.A.)
| | - Shahad Alqahtani
- Pharmacy Department, King Fahad Medical City, Riyadh 11451, Saudi Arabia;
| | - Hamoud Almotairi
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia; (B.B.); (H.A.)
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Yang J, Liu R, Ektare V, Stephens J, Shelbaya A. Does Biosimilar Bevacizumab Offer Affordable Treatment Options for Cancer Patients in the USA? A Budget Impact Analysis from US Commercial and Medicare Payer Perspectives. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2021; 19:605-618. [PMID: 33506318 PMCID: PMC8270829 DOI: 10.1007/s40258-021-00637-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/03/2021] [Indexed: 05/11/2023]
Abstract
BACKGROUND Bevacizumab remains the most widely used and most thoroughly characterized angiogenesis inhibitor for a range of advanced cancers. Bevacizumab-bvzr (Zirabev®), a biosimilar of bevacizumab, was recently approved by the US Food and Drug Administration (FDA), which provides a less costly option. This study aimed to evaluate the financial impact of introducing bevacizumab-bvzr from US commercial and Medicare payer perspectives. METHODS A Microsoft Excel-based budget impact model was developed over a 5-year time horizon. Target population was patients to be treated with bevacizumab for FDA-approved indications. Drug costs (2020 US$) were based on average sales price and wholesale acquisition cost, accounting for payer-specific reimbursement models and provider settings. Drug dosing and duration were based on prescribing information and pivotal trial publications. RESULTS In a hypothetical 10-million-member health plan, 503 and 723 patients were estimated to be treated with bevacizumab in year 1 and year 5, respectively. Assuming an annual market shift of 1.7%, 3.6%, 6.7%, 9.4%, and 11.9% to bevacizumab-bvzr, an annual cost saving of $313,363 ($0.003 per member per month [PMPM]) was estimated for a commercial payer and $92,880 ($0.001 PMPM) for Medicare in year 1. Cumulative 5-year cost savings were $7,030,924 ($0.012 PMPM) for a commercial payer and $4,059,257 ($0.007 PMPM) for Medicare. More than half of the cost savings was attributed to patients with metastatic colorectal cancer. CONCLUSIONS The introduction of biosimilar bevacizumab-bvzr was estimated to provide substantial cost savings for US payers, which would allow additional patients access to bevacizumab treatment.
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Affiliation(s)
- Jingyan Yang
- Patient Health and Impact (PHI), Pfizer Inc., 235 East 42nd Street, New York, NY, 10017, USA.
- Institute for Social and Economic Research and Policy (ISERP), Columbia University, New York, NY, USA.
| | - Rongzhe Liu
- Pharmerit, an OPEN Health Company, Bethesda, MD, USA
| | - Varun Ektare
- Pharmerit, an OPEN Health Company, Bethesda, MD, USA
| | | | - Ahmed Shelbaya
- Patient Health and Impact (PHI), Pfizer Inc., 235 East 42nd Street, New York, NY, 10017, USA
- Mailman School of Public Health, Columbia University, New York, NY, USA
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Peeters M, Planchard D, Pegram M, Gonçalves J, Bocquet F, Jang H. Biosimilars in an era of rising oncology treatment options. Future Oncol 2021; 17:3881-3892. [PMID: 34189937 DOI: 10.2217/fon-2021-0546] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
New diagnostic technologies, including molecular profiling, have enabled advances in treatments of various cancers; this has significantly improved clinical outcomes, including overall survival. However, the high cost of biologic drugs may prevent patients from having access to optimal treatment. Introduction of lower priced biosimilar agents into the therapeutic armamentarium brings the potential to ease the burden on healthcare expenditure and facilitate better access to effective cancer treatments. Oncology biosimilars have shown comparable efficacy and safety based on clinical evidence and physicochemical quality data as well as in real-world settings. This paper aims to review changes in the management of oncology treatment and their implication with respect to biosimilars.
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Affiliation(s)
- Marc Peeters
- Department of Oncology, Antwerp University Hospital, Belgium
| | - David Planchard
- Department of Medical Oncology, Thoracic Unit, Institut Gustave Roussy, Villejuif, France
| | - Mark Pegram
- Stanford Comprehensive Cancer Institute, Stanford University School of Medicine Stanford, CA, USA
| | - João Gonçalves
- iMed-Research Institute for Medicines, Faculty of Pharmacy at University of Lisbon, Lisbon, Portugal
| | - François Bocquet
- Oncology Data Factory & Analytics Department, Institut de Cancérologie de l'Ouest, Nantes-Angers, France
| | - Harah Jang
- Samsung Bioepis Co., Ltd, Incheon, Republic of Korea
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Long-term efficacy and safety of CT-P6 versus trastuzumab in patients with HER2-positive early breast cancer: final results from a randomized phase III trial. Breast Cancer Res Treat 2021; 188:631-640. [PMID: 34148205 PMCID: PMC8272708 DOI: 10.1007/s10549-021-06240-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 04/20/2021] [Indexed: 12/20/2022]
Abstract
PURPOSE Equivalent efficacy was demonstrated for the biosimilar CT-P6 and trastuzumab following neoadjuvant therapy for patients with human epidermal growth factor receptor-2 (HER2)-positive early breast cancer. Following adjuvant treatment, efficacy and safety were comparable between treatments. We report updated safety and efficacy data after up to 3 years' follow-up. METHODS Following neoadjuvant chemotherapy with CT-P6/trastuzumab, patients underwent surgery and continued receiving adjuvant CT-P6/trastuzumab. The primary endpoint (previously reported) was pathological complete response. Time-to-event analyses (disease-free survival [DFS], progression-free survival [PFS], and overall survival [OS]), study drug-related and cardiac adverse events, and immunogenicity were assessed during post-treatment follow-up. RESULTS Most patients entered the follow-up period (CT-P6: 259 [95.6%]; trastuzumab: 269 [96.8%]). After a median follow-up of 38.7 (CT-P6) and 39.6 (trastuzumab) months, medians were not reached for time-to-event parameters; estimated hazard ratios (HRs) and 3-year survival rates were similar between groups. Estimated HRs (95% confidence intervals) for CT-P6 versus trastuzumab were 1.23 (0.78-1.93) for DFS, 1.31 (0.86-2.01) for PFS, and 1.10 (0.57-2.13) for OS (intention-to-treat population). Safety findings were comparable between groups for the overall study and follow-up period, including study drug-related cardiac disorders (CT-P6: 22 [8.1%] patients; trastuzumab: 24 [8.6%] patients [overall]) and decreases in left ventricular ejection fraction. Immunogenicity was similar between groups. CONCLUSION The similarity of the time-to-event analyses between CT-P6 and trastuzumab supports the equivalence in terms of efficacy established for the primary endpoint. CT-P6 was well tolerated, with comparable safety and immunogenicity to trastuzumab. ClinicalTrials.gov: NCT02162667 (registered June 13, 2014).
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Waller CF, Möbius J, Fuentes-Alburo A. Intravenous and subcutaneous formulations of trastuzumab, and trastuzumab biosimilars: implications for clinical practice. Br J Cancer 2021; 124:1346-1352. [PMID: 33589773 PMCID: PMC8039027 DOI: 10.1038/s41416-020-01255-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 12/17/2020] [Indexed: 11/29/2022] Open
Abstract
Trastuzumab is a biologic therapy indicated for the treatment of human epidermal growth factor receptor 2 (HER2)-positive breast cancer and metastatic gastric cancer. Trastuzumab was originally approved as an intravenous (IV) formulation but has since been developed for subcutaneous (SC) administration for patients with HER2-positive breast cancer. Both formulations demonstrate generally comparable pharmacological and clinical profiles. Therefore, when deciding between treatment options, factors such as the route of administration, patient preference, value and cost must be considered. Studies comparing IV with SC trastuzumab indicate that each formulation offers unique advantages to patients depending on their individual needs. Concurrent with the development of SC trastuzumab, IV trastuzumab biosimilars comprise another treatment option that, in view of their reduced cost, might improve patient access and increase cost-effectiveness for healthcare providers and payers. In this review, we seek to raise awareness of the current options available for trastuzumab so that healthcare providers can optimally treat patients according to their individual situations and preferences.
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Affiliation(s)
- Cornelius F Waller
- Department of Haematology, Oncology and Stem Cell Transplantation, University Medical Centre Freiburg and Faculty of Medicine, University of Freiburg, Freiburg, Germany.
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Abstract
Over the past 3 decades, monoclonal antibodies and their related derivatives, including recently approved antibody-drug conjugates, conquered a central role in cancer therapy because of their contribution to improve survival, time to progression and quality of life of patients compared to chemotherapy protocols. This review summarizes information on approved original and biosimilar products, as well as investigational antibody-based therapeutics, targeting ErbB2. This target has been selected as a paradigmatic example because of its relevant role in sustaining the malignancy of major cancer diseases including, breast, gastric and other chemotherapy-resistant solid tumors. This work analyzes the drivers affecting research and development of next-generation anti-ErbB2 immunotherapeutics, taking into account unmet medical needs and pharmacoeconomic issues related to sustainability. The analysis may help with the design of future research and development strategies.
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Affiliation(s)
- Rita De Santis
- Biotechnology Research and Development, Alfasigma SpA, Rome, Italy
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21
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Budget Impact Analysis of the Introduction of Rituximab and Trastuzumab Intravenous Biosimilars to EU-5 Markets. BioDrugs 2020; 35:89-101. [PMID: 33368051 PMCID: PMC7803676 DOI: 10.1007/s40259-020-00461-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2020] [Indexed: 12/14/2022]
Abstract
Background Biologic treatments impose a large financial burden on healthcare payers. Subcutaneous formulations of trastuzumab and rituximab offer administration cost savings relative to the intravenous products through reduced preparation and infusion times. However, intravenous biosimilars have the potential to offset administration costs through lower drug costs. Objective The objective was to develop a budget impact model (BIM) from a payer’s perspective for the EU-5 countries (UK, France, Germany, Spain, Italy) to demonstrate the economic impact of using intravenous trastuzumab and rituximab biosimilars. Methods An incidence-based BIM was developed to estimate the net budget impact utilising epidemiology data from the literature, market research data on the use of relevant treatments in all approved indications, and corresponding costs. The budget impact was estimated for 5 years following introduction of the biosimilars. Results Analysis using the base-case results indicated that adoption of the biosimilars trastuzumab and rituximab would result in net cost savings. At year 5, the net budget saving ranged from €4.05 million to 303.86 million for rituximab and from €19 million to 172 million for trastuzumab. The cost saving could potentially extend treatment to 291–15,671 more patients with rituximab and 622–3688 more patients with trastuzumab. Conclusion This budget impact analysis emphasised that increased use of intravenous rituximab and trastuzumab biosimilars may result in cost savings from the payer’s perspective across the EU-5 countries. Supplementary Information The online version contains supplementary material available at 10.1007/s40259-020-00461-8.
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Huang HY, Liu CC, Yu Y, Wang L, Wu DW, Guo LW, Wang SH, Fang H, Bai Y, Fang Y, Fan Q, Sun C, Wu Y, Shi JF, Ma F, Tang Y, Dai M, Li N. Pharmacoeconomic Evaluation of Cancer Biosimilars Worldwide: A Systematic Review. Front Pharmacol 2020; 11:572569. [PMID: 33536905 PMCID: PMC7849203 DOI: 10.3389/fphar.2020.572569] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 10/06/2020] [Indexed: 12/21/2022] Open
Abstract
Background and Purpose: The availability of oncology biosimilars is deemed as a fundamental strategy to achieve sustainable health care. However, there is scarce systematic evidence on economic effectiveness of cancer biosimilars. We aimed to synthesize evidence from pharmacoeconomic evaluation of oncology biosimilars globally, provide essential data and methodological reference for involved stakeholders. Materials and Methods: This systematic review was conducted in PubMed, embase, the Cochrane library, CRD, ISPOR and NICE utill December 31, 2019. Information on basic characteristics, evaluation methodology and results were extracted. Quality of included studies was assessed using the Consolidated Health Economic Evaluation Reporting Standards Checklist. Results: For 17 studies identified (13 from Europe and four from United States), the overall quality was generally acceptable. A total of seven biological molecules involved with filgrastim, EPOETIN α, and trastuzumab leading the three. The mostly common evaluation perspective was payer, but the time horizon varied greatly. There were ten studies which adopted cost minimization analysis to evaluate efficiency while seven studies adopted budget impact analysis to address affordability, with cost ratio and cost saving being its corresponding primary endpoint. Although the comparability of included studies was limited and specific results were largely affected by uptake and price discount rates of the oncology biosimilar, the comprehensive results consistently favored its promotion. Conclusion: Globally, the economic evaluation of cancer biosimilars is in its initial phase. However, limited evidence from developed countries consistently supported both cost-effectiveness of efficiency and affordability of oncology biosimilars, while they were largely affected by uptake and price discount rate.
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Affiliation(s)
- Hui-Yao Huang
- Clinical Trials Center, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Cheng-Cheng Liu
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yue Yu
- Clinical Trials Center, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Le Wang
- Institute of Cancer and Basic Medicine, Cancer Hospital of the University of Chinese Academy of Sciences, Hangzhou, China
| | - Da-Wei Wu
- Clinical Trials Center, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lan-Wei Guo
- Office for Cancer Control and Research, Henan Cancer Hospital, Zhengzhou University, Zhengzhou, China
| | - Shu-Hang Wang
- Clinical Trials Center, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hong Fang
- Clinical Trials Center, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ying Bai
- Clinical Trials Center, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yuan Fang
- Clinical Trials Center, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qi Fan
- Clinical Trials Center, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Chao Sun
- Clinical Trials Center, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ying Wu
- Pfizer Investment Co., Ltd., Shanghai, China
| | - Ju-Fang Shi
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fei Ma
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yu Tang
- Clinical Trials Center, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Min Dai
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ning Li
- Clinical Trials Center, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Rezk MF, Pieper B. Unlocking the Value of Anti-TNF Biosimilars: Reducing Disease Burden and Improving Outcomes in Chronic Immune-Mediated Inflammatory Diseases: A Narrative Review. Adv Ther 2020; 37:3732-3745. [PMID: 32740789 PMCID: PMC7444394 DOI: 10.1007/s12325-020-01437-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Indexed: 02/07/2023]
Abstract
Immune-mediated inflammatory diseases (IMIDs) are chronic conditions that create a significant disease burden on millions of patients while adding a major financial burden to societies and healthcare systems. The introduction of biologic medicines has contributed majorly to improving the clinical outcomes of IMIDs and as such these modalities have gained first- or second-line positions in a wide range of treatment guidelines from different international clinical societies. However, the high cost of these biologics traditionally limited their accessibility and delayed their initiation, leaving millions of patients with unmet medical needs for a more affordable and sustainable solution. The introduction of cost-efficient biosimilar anti-TNFs within Europe since 2013 has allowed more patients with IMIDs to access biologic therapies earlier and for longer, potentially altering the course of the disease into a milder phenotype and reducing the long-term disease burden. This review provides the latest evidence for the impact of biosimilars on patient outcomes and demonstrates their clinical value beyond a reduction in price.
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Affiliation(s)
- Mourad F Rezk
- Biogen International GmbH, Neuhofstrasse 30, 6340, Baar, Switzerland.
| | - Burkhard Pieper
- Biogen International GmbH, Neuhofstrasse 30, 6340, Baar, Switzerland
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Simoens S. How do biosimilars sustain value, affordability, and access to oncology care? Expert Rev Pharmacoecon Outcomes Res 2020; 21:327-329. [PMID: 32842809 DOI: 10.1080/14737167.2020.1813570] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Steven Simoens
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
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Zinzani PL, Dreyling M, Gradishar W, Andre M, Esteva FJ, Boulos S, González Barca E, Curigliano G. Are Biosimilars the Future of Oncology and Haematology? Drugs 2019; 79:1609-1624. [PMID: 31541401 DOI: 10.1007/s40265-019-01193-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Biological drugs are vital but often high-cost components of cancer treatment. Several biosimilar versions of these drugs have been approved in Europe and/or the USA, with many more in development. However, there is some disconnect between the biosimilars that are approved for use and those accessible in clinical practice, with availability impacted by factors including patent litigation and complex healthcare insurance policies, particularly in the USA. Provided the barriers to widespread uptake can be overcome, biosimilars offer potential benefits including cost savings and improved patient access versus the reference product (RP). This article provides an up-to-date and focused perspective on the development and use of biosimilars in the haemato-oncology setting. European and US regulatory pathways governing biosimilar licensing demand that there are no clinically meaningful differences between a biosimilar and its RP. Pathways are rigorously enforced and involve comprehensive non-clinical evaluations and clinical trials in selected indications to establish the equivalence or non-inferiority of efficacy, and the comparability of safety, of the biosimilar versus its RP. 'Indication extrapolation' is only permitted if scientifically justifiable considering mechanism(s) of action, pharmacokinetics, immunogenicity and safety in relevant patient populations. Switching treatment from RP to biosimilar is supported by most available data, predominantly from indications other than cancer, and post-marketing pharmacovigilance programmes are warranted. Notably, the potential benefits of biosimilar cancer treatment may extend beyond direct cost savings: for example, the availability of biosimilars of common regimen components may help incentivise the evaluation and/or clinical use of new treatment approaches and novel drugs.
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Affiliation(s)
- Pier Luigi Zinzani
- Institute of Hematology, "Seragnoli" University of Bologna, Bologna, Italy
| | - Martin Dreyling
- Medizinische Klinik III, Klinikum der Universitat Munchen, LMU Munich, Munich, Germany
| | - William Gradishar
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Marc Andre
- Universite Catholique de Louvain, CHU UCL Namur, Yvoir, Belgium.,Pôle de Recherche Mont, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Yvoir, Belgium
| | | | - Suliman Boulos
- Hemato-Oncology Inpatient Department, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Eva González Barca
- Institut Català d'Oncologia, IDIBELL, Hospitalet de Llobregat, Barcelona, Spain
| | - Giuseppe Curigliano
- Department of Oncology and Hemato-Oncology, University of Milano, Milano, Italy. .,European Institute of Oncology, IRCCS, Milano, Italy.
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