EXPANDED ACCESS TO PEMBROLIZUMAB FROM COST-SAVINGS GENERATED BY BIOSIMILAR FILGRASTIM (BIOSIM-FIL) IN THE PROPHYLAXIS OF CHEMOTHERAPY-INDUCED (FEBRILE) NEUTROPENIA (CIN/FN)- SIMULATION STUDY
Author(s)
McBride A1, Balu S2, Campbell K2, Bikkina M2, MacDonald K3, Abraham I4
1University of Arizona Cancer Center, Tucson, AZ, USA, 2Sandoz, Inc., Princeton, NJ, USA, 3Matrix45, LLC, Tucson, AZ, USA, 4University of Arizona, Tucson, AZ, USA
OBJECTIVES: CIN/FN prophylaxis with BIOSIM-FIL may offer cost-savings over reference filgrastim (FIL) and pegfilgrastim (PEGFIL). The objectives were to [1] simulate, for a 20,000 patient panel, cost-savings achieved from CIN/FN prophylaxis with BIOSIM-FIL over FIL and PEGFIL; [2] estimate the budget-neutral expanded access to pembrolizumab treatment from these cost-savings; [3] determine the number-needed-to-convert (NNC) to purchase one additional pembrolizumab treatment. METHODS: Simulation analysis using 3Q2016 average selling price (ASP; US$) cost for one patient for one chemotherapy cycle with 5, 7, 11, or 14 days of prophylaxis. For a 20,000-patient panel, we calculated [1] cost-savings (US $) accrued from 5/7/11/14d prophylaxis converted to BIOSIM-FIL; [2] expanded access afforded by these cost-savings to pembrolizumab (1 administration Q3W for 2 years at $153,673); [3] NNC for one additional pembrolizumab treatment. RESULTS: Per-cycle cost-savings from BIOSIM-FIL over FIL were $327.00 (5d), $457.80 (7d), $719.40 (11d), and $915.60 (14d). For 20,000 patients, conversion from FIL to BIOSIM-FIL yields savings of (rounded) $6,450,000 (5d), $9,156,000(7d), $14,388,000 (11d), $18,312,000 (14d). These savings provide expanded access to 2y of pembrolizumab treatment to 43 (5d BIOSIM-FIL regimen), 60 (7d), 94 (11d), and 119 (14d) patients. The NNC is 470 (5d), 336 (7d), 214 (11d), and 168 (14d). As conversion-related savings relative to PEGFIL decline as daily injections increase, for 20,000 patients, conversion from PEGFIL to BIOSIM-FIL yields savings of $55,893,600 (5d), $47,177,600 (7d), $29,745,600 (11d), $16,671,600 (14d). These savings provide expanded access to 2y of pembrolizumab treatment to 364 (5d BIOSIM-FIL regimen), 307 (7d), 194 (11d), and 108 (14d) patients. The NNC is 55 (5d), 65 (7d), 103 (11d), and 184 (14d). CONCLUSIONS: Conversion from reference FIL and PEGFIL to BIOSIM-FIL not only yields significant savings, especially when converting from PEGFIL, but these savings can be applied to procure therapeutic cancer care with pembrolizumab on a budget-neutral basis.
Conference/Value in Health Info
2017-11, ISPOR Europe 2017, Glasgow, Scotland
Value in Health, Vol. 20, No. 9 (October 2017)
Code
PCN175
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies, Cost-comparison, Effectiveness, Utility, Benefit Analysis
Disease
Oncology