OBJECTIVES : Biosimilars are approved by the FDA based on comparable efficacy and safety to the reference product and are priced competitively. The purpose of this study is to inform United States hospital decision makers of the potential budget impact of introducing infliximab biosimilars as a treatment option for all approved indications.

METHODS : An Excel-based budget impact model was developed over a five-year time horizon from the outpatient hospital perspective. Initial size of the prevalent Medicare population utilizing infliximab for Rheumatoid Arthritis (RA), Crohn’s Disease (CD), Ulcerative Colitis (UC), Ankylosing Spondylitis (AS), Psoriatic Arthritis (PA), or Plaque Psoriasis (PP) were based on data retrieved from the hospital electronic medical record for fiscal year 2018. Only drug acquisition and drug administration costs were assessed under the assumption that infliximab biosimilars (infliximab-abda and infliximab-dyyb) are comparable to the reference product. Cost inputs were based on average sales price from quarter 4 2018 and Medicare payment for drug administration services. A scenario assuming 80% market uptake from years 1 to 5 of each infliximab biosimilar was compared to the reference case scenario (no use of infliximab biosimilars). Budget impact was assessed by calculating the incremental cost difference between the scenario with each infliximab biosimilar and the reference case scenario.

RESULTS : In a hypothetical cohort of 41 patients receiving infliximab, 13 patients had RA, 15 had CD, 7 had UC, 2 had AS, 4 had PA, and 0 had PP. In the reference case scenario, cumulative 3 and 5 year total cost was $3,052,393 and $5,087,322, respectively. Cumulative savings with infliximab-abda over 3 and 5 years totaled $123,140 and $383,651, respectively. Cumulative savings with infliximab-dyyb over 3 and 5 years totaled $148,864 and $460,825, respectively.

CONCLUSIONS : The introduction of infliximab biosimilars resulted in budget savings compared to the reference case, with infliximab-dyyb resulting in more savings than infliximab-abda.