OBJECTIVES: It is unknown whether using pegfilgrastim biosimilars are cost-saving in real-world setting. This study compared medical costs including pegfilgrastim drug costs and febrile neutropenia (FN)-related costs between pegfilgrastim biosimilars (pegfilgrastim-jmdb, pegfilgrastim-cbqv) and originator users.

METHODS: A retrospective cohort study using 2019 IBM MarketScan Commercial and Medicare Supplemental database was conducted in adult patients with cancer initiating myelosuppressive chemotherapy courses. At least 2 cancer diagnosis (at least 7 days apart) were required within 30 days of chemotherapy initiation date. Pegfilgrastim costs included drug costs only (excluded administration fee). FN-related costs included all FN related healthcare utilizations which were defined as having neutropenia, fever, or infection diagnosis. Per person per cycle (PPPC) out-of-pocket (OOP) costs, health plan costs, and total costs were compared between originator and biosimilars users in cycle 1. A generalized linear model with log link function and a two-part model were used.

RESULTS: A total of 1,930 patients were included (884 used pegfilgrastim originator, 427 used pegfilgrastim-jmdb, 619 used pegfilgrastim-cbqv). Adjusted OOP pegfilgrastim PPPC costs were significantly lower for the biosimilars versus the originator ($299 for originator vs $182 for pegfilgrastim-jmdb, and $159 for pegfilgrastim-cbqv, p-value <0.0001 for both comparisons). However, there was no difference in health plan costs and total costs. In addition, no difference was observed for adjusted FN-related PPPC total costs, health plan costs, and OOP costs. FN-related total costs were $3,085 for pegfilgrastim originator, $3,162 for pegfilgrastim-jmdb (p-value=0.871), $3,283 for pegfilgrastim-cbqv (p-value=0.682); FN-related health plan costs were $2,804 for pegfilgrastim originator, $2,970 for pegfilgrastim-jmdb (p-value=0.692), $2,745 for pegfilgrastim-cbqv (p-value=0.879); FN-related OOP costs were $192 for pegfilgrastim originator, $197 for pegfilgrastim-jmdb (p-value=0.958), $240 for pegfilgrastim-cbqv (p-value=0.68).

CONCLUSIONS: In a commercially insured population, using pegfilgrastim biosimilars led to cost-savings for patients, but not payers. No difference in FN treatment costs was observed.