Simulation models demonstrate substantial cost-savings realized by conversion to biosimilar pegfilgrastim-cbqv for chemotherapy-induced (febrile) neutropenia prophylaxis in patients with metastatic pancreatic cancer, and that these cost-savings could be reallocated to provide access to antineoplastic treatment on a budget-neutral basis.
A simulation modeling was performed to demonstrate that cost-savings generated from conversion of pegfilgrastim reference to biosimilar pegfilgrastim-cbqv for the prophylaxis of chemotherapy-induced (febrile) neutropenia in metastatic pancreatic cancer could be reallocated on a budget-neutral basis to provide expanded access to additional prophylaxis or to antineoplastic therapy. The results of this analysis were presented at the 2021 American Society of Clinical Oncology Annual Meeting.
In this study, the following simulations were modeled: (1) cost-savings realized from using biosimilar pegfilgrastim-cbqv (BIOSIM-PEG) instead of reference pegfilgrastim with or without on-body injector (PEG/PEG-OBI); (2) the potential for cost-savings achieved from converting to BIOSIM-PEG to provide expanded access to BIOSIM-PEG or chemotherapy with oxaliplatin, leucovorin, irinotecan, and fluorouracil (FOLFIRINOX); and (3) the number-needed-to-convert (NNC) to BIOSIM-PEG to purchase 1 additional treatment of BIOSIM-PEG or FOLFIRINOX.
This simulation modeling utilized a hypothetical panel of 2500 patients with metastatic pancreatic cancer. Three cost inputs for medication costs were: (1) Average Sales Price, derived from the Centers for Medicare & Medicaid Services Q4 2020 reimbursement; (2) wholesale acquisition cost (RED BOOK); (3) a blended Average Sales Price/wholesale acquisition cost rate proportionate to the estimated 2020 incident pancreatic cancer age distribution per the Surveillance, Epidemiology, and End Results Program. Conversion rates from PEG/PEG-OBI to BIOSIM-PEG ranging from 10% to 100% between 1 and 12 cycles of FOLFIRINOX were modeled.
In this metastatic pancreatic cancer cohort, cost-savings of using BIOSIM-PEG instead of PEG/PEG-OBI ranged from $188,780 (1 cycle at 10% conversion) to $22,653,609 (12 cycles at 100% conversion). The cost-savings for 1 cycle of chemotherapy translated into expanded access to additional BIOSIM-PEG prophylaxis, ranging from 106 cycles at 10% conversion to 1055 cycles at 100% or to between 643 and 4428 cycles of FOLFIRINOX, respectively. The cost-savings over 12 cycles could provide up to 6330 additional cycles of BIOSIM-PEG or 38,571 cycles of FOLFIRINOX (at 100% conversion). The NNC from PEG/PEG-OBI to purchase 1 additional cycle of BIOSIM-PEG is 2.37; the NNC to purchase 1 cycle of FOLFIRINOX is 0.39.
These simulated models demonstrate substantial cost-savings for chemotherapy-induced (febrile) neutropenia prophylaxis realized by conversion to biosimilar pegfilgrastim-cbqv; these cost-savings could be reallocated to provide access to antineoplastic treatment on a budget-neutral basis.
Source: McBride A, MacDonald K, Abraham I. Cost efficiency and budget-neutral expanded access to antineoplastic therapy from cost-savings derived from conversion to biosimilar pegfilgrastim-cbqv for the prophylaxis of chemotherapy-induced (febrile) neutropenia (CIN/FN): simulation modeling in metastatic pancreatic cancer. J Clin Oncol. 2021;39(suppl_3):441-441.
