BUDGET IMPACT OF INTRODUCING A SECOND BEVACIZUMAB BIOSIMILAR FOR METASTATIC COLORECTAL CANCER IN MOROCCO: A FIVE-YEAR ANALYSIS FROM THE MANDATORY HEALTH INSURANCE PERSPECTIVE
Author(s)
Omar Maoujoud, MD, PhD1, Abderrazag souraya, Msc2, nesrine aouida, Msc3.
1ISPOR Morocco, Research Team of pharmacoeconomics & pharmacoepidemiology, Faculty of Medicine Mohammed V University, Rabat, Morocco, 2ABBOTT, Inc, Algeria, 3ABBOTT, Inc, Tunisia.
1ISPOR Morocco, Research Team of pharmacoeconomics & pharmacoepidemiology, Faculty of Medicine Mohammed V University, Rabat, Morocco, 2ABBOTT, Inc, Algeria, 3ABBOTT, Inc, Tunisia.
OBJECTIVES: To estimate the budget impact, for Moroccan Mandatory Health Insurance (Assurance Maladie Obligatoire, AMO), of introducing a second bevacizumab biosimilar for metastatic colorectal cancer (mCRC), and to characterise decision uncertainty around projected payer savings.
METHODS: A prevalence-based budget impact model compliant with ISPOR BIA Good Practice Guidelines was developed in Microsoft Excel, from the AMO payer perspective, over a five-year horizon (2026 to 2030), capturing direct drug costs (undiscounted). The eligible population was derived from a local epidemiological cascade (GLOBOCAN incidence; published proportions), combining first- and second-line patients (Year 1: n=1,650; growth 1%/year). The reference annual cost was MAD 174,038 per patient (6,860 mg mean dose; volume-weighted national public prices, Medicament.ma). The reference market (originator plus first biosimilar) was compared with a second biosimilar reaching 40% share by 2030 at a 10% discount. Uncertainty was assessed through deterministic one-way analyses and a probabilistic sensitivity analysis (PSA; 10,000 Monte Carlo iterations, fixed seed), assigning Beta distributions to epidemiological proportions, Gamma to incidence, and Normal to dose.
RESULTS: The undiscounted five-year reference budget was MAD 1.48 billion. The base case yielded cumulative savings of MAD 37.3 million, rising from MAD 2.9 million (2026) to MAD 12.1 million (2030). Deterministic analyses ranged from MAD 26.9 to 44.8 million, driven by population size and uptake speed; entry discounts of 5% and 15% produced MAD 18.6 and 55.9 million. The PSA gave mean savings of MAD 37.1 million (95% credible interval 22.7 to 56.0 million), with the introduction cost-saving in 100% of iterations.
CONCLUSIONS: Introducing a second bevacizumab biosimilar offers the Moroccan payer robust, scalable savings at equivalent clinical efficacy, without restricting access. Savings stayed positive across all probabilistic iterations, and the discount-to-savings gradient is directly usable in negotiation. Findings support multi-biosimilar competition as an oncology affordability lever; validation requires observed consumption and national registry data.
METHODS: A prevalence-based budget impact model compliant with ISPOR BIA Good Practice Guidelines was developed in Microsoft Excel, from the AMO payer perspective, over a five-year horizon (2026 to 2030), capturing direct drug costs (undiscounted). The eligible population was derived from a local epidemiological cascade (GLOBOCAN incidence; published proportions), combining first- and second-line patients (Year 1: n=1,650; growth 1%/year). The reference annual cost was MAD 174,038 per patient (6,860 mg mean dose; volume-weighted national public prices, Medicament.ma). The reference market (originator plus first biosimilar) was compared with a second biosimilar reaching 40% share by 2030 at a 10% discount. Uncertainty was assessed through deterministic one-way analyses and a probabilistic sensitivity analysis (PSA; 10,000 Monte Carlo iterations, fixed seed), assigning Beta distributions to epidemiological proportions, Gamma to incidence, and Normal to dose.
RESULTS: The undiscounted five-year reference budget was MAD 1.48 billion. The base case yielded cumulative savings of MAD 37.3 million, rising from MAD 2.9 million (2026) to MAD 12.1 million (2030). Deterministic analyses ranged from MAD 26.9 to 44.8 million, driven by population size and uptake speed; entry discounts of 5% and 15% produced MAD 18.6 and 55.9 million. The PSA gave mean savings of MAD 37.1 million (95% credible interval 22.7 to 56.0 million), with the introduction cost-saving in 100% of iterations.
CONCLUSIONS: Introducing a second bevacizumab biosimilar offers the Moroccan payer robust, scalable savings at equivalent clinical efficacy, without restricting access. Savings stayed positive across all probabilistic iterations, and the discount-to-savings gradient is directly usable in negotiation. Findings support multi-biosimilar competition as an oncology affordability lever; validation requires observed consumption and national registry data.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE280
Topic
Economic Evaluation, Health Policy & Regulatory, Health Technology Assessment
Topic Subcategory
Budget Impact Analysis, Cost/Cost of Illness/Resource Use Studies
Disease
Oncology, Urinary/Kidney Disorders