Sandoz Inc, Princeton, NJ.
University of Arizona Cancer Center, University of Arizona College of Pharmacy, Tucson, AZ.
JCO Oncol Pract. 2021 Aug;17(8):e1139-e1149. doi: 10.1200/OP.20.00994. Epub 2021 May 7.
PURPOSE: Value-based programs, such as the Oncology Care Model (OCM), seek to improve care for patients undergoing chemotherapy, while reducing total costs. The purpose of this study is to quantify the impact of adopting biosimilar granulocyte colony-stimulating factors (G-CSFs) for febrile neutropenia (FN) primary prophylaxis (PP) from a US practice perspective. METHODS: A 1-year economic analysis on real-world direct drug costs and health care resource utilization was conducted in a hypothetical cohort of 500 patients with nonmyeloid cancer receiving chemotherapy. The first model simulated total cost savings of biosimilar versus reference G-CSFs over six cycles of chemotherapy. The second model evaluated cost and outcome implications of expanding the use of biosimilar G-CSFs to an additional 10% of patients at intermediate FN risk. RESULTS: Based on real-world evidence over 1 year, a total of 121 of 500 patients received G-CSF prophylaxis resulting in cost savings that ranged from $0.54M US dollars (USD) (short-acting, eg, filgrastim) to $1.68M USD (long-acting, eg, pegfilgrastim) when switching from reference to biosimilar G-CSFs. Expanding the use of biosimilar G-CSFs allowed an additional 24 patients to receive prophylaxis of FN, leading to cost savings of $0.03M USD or $1.19M USD, with a reduction of $0.08M USD in FN-related resource utilization cost. The per-patient per-year cost saving for long-acting G-CSFs was about $3,000 USD. CONCLUSION: The implementation of biosimilar versus reference G-CSFs to OCM-participating practices results in a reduction of costs and facilitates achieving OCM metrics by improving patients' outcomes while expanding biosimilar G-CSFs access to patients at intermediate risk of chemotherapy-induced FN.
目的:价值为基础的方案,如肿瘤护理模式(OCM),旨在改善接受化疗的患者的护理,同时降低总成本。本研究的目的是从美国实践的角度量化采用生物类似粒细胞集落刺激因子(G-CSF)治疗发热性中性粒细胞减少症(FN)一级预防(PP)对成本的影响。
方法:对 500 名接受化疗的非髓性癌症患者的现实药物成本和医疗资源利用情况进行了为期一年的经济分析。第一个模型模拟了在 6 个化疗周期中,生物类似物与参照 G-CSF 相比的总节省成本。第二个模型评估了将生物类似物 G-CSF 扩大应用于 10%中等 FN 风险患者的成本和结果影响。
结果:基于 1 年的真实数据,在 500 名患者中,共有 121 名接受 G-CSF 预防治疗,与参照 G-CSF 相比,切换为生物类似物 G-CSF 可节省 540 万美元(短效,如非格司亭)至 1680 万美元(长效,如培非格司亭)。扩大生物类似物 G-CSF 的应用范围使另外 24 名患者能够接受 FN 的预防治疗,节省 30 万美元或 1190 万美元的成本,并降低与 FN 相关的资源利用成本 80 万美元。长效 G-CSF 的每位患者每年的节省成本约为 3000 美元。
结论:OCM 参与实践中实施生物类似物与参照 G-CSF 相比,降低了成本,并通过改善患者的结局,扩大了生物类似物 G-CSF 对化疗诱导 FN 中危患者的应用,从而有助于实现 OCM 指标。
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