AMCP Nexus Abstracts Investigate Adoption, Budget Impact of Biosimilars

Abstracts presented at the Academy of Managed Care Pharmacy (AMCP) Nexus meeting explored the adoption of infliximab biosimilars, utilization patterns of bevacizumab biosimilars in ophthalmology and oncology settings, and the budget impact of transferring patients to a natalizumab biosimilar from the originator.

Adoption of Infliximab Biosimilars

Regence health plans achieved over 90% adoption of infliximab biosimilars and saved $0.62 per member per month during Q1 2022.¹

Medical benefit drug claims for infliximab products were examined from January 2021 to March 2022 for a 1.6 million member commercial payer. The data included biosimilar claim utilization as a percentage all infliximab claims as well as infliximab-related net cost savings. Strategies that were implemented to promote biosimilar adoption consisted of developing messaging about the benefits of biosimilars, coordinated communication with embers and providers, and prior authorization configuration to instill an easy transition.

Utilization of infliximab biosimilars increased from 8% to 94% over 3 years. Initial net savings from using infliximab biosimilars was $2 million over a 3-month post period.

The researchers suggested that having several communication channels between members and providers, a clinically appropriate and thoughtful medical policy, and a prior authorization management plan are critical to achieving early adoption results. Also, longer follow-up and evaluation periods are needed to define long-term strategy savings and success.

Use of Bevacizumab Biosimilars in 2 Fields

Use of bevacizumab biosimilars increased in recent years relative to the originator (Avastin) in the oncology and ophthalmology spaces. Bevacizumab products are indicated for the treatment of several forms of cancer and are often used off-label in the treatment of some retinal conditions.

A retrospective cohort study using data from the Biologics and Biosimilars Collective Intelligence Consortium and assess the utilization patterns of 2 bevacizumab biosimilars (Mvasi, Zirabev) between January 2010 and December 2020.²

Users of bevacizumab were mostly female (61.8%) and had a mean age of 63 years. Patient use of bevacizumab in oncology increased over time, with 5% of the population using a biosimilar. Total bevacizumab product utilization increased for retinal conditions starting in 2015 but decreased for age-related macular degeneration after 2016. Use of biosimilars began to increase in the beginning of 2019 for proliferative diabetic retinopathy.

The researchers noted that there is limited data on the use of bevacizumab biosimilars, and future research should assess the frequency and indication of use for these medications.

Budget Impact of a Natalizumab Biosimilar

Adoption of a natalizumab biosimilar once one becomes available could result in significant cost savings to US health plans, which could be reinvested to increase treatment access to patients with relapsing remitting multiple sclerosis (RRMS), according to one abstract.³

Researchers estimated the 3-year budget impact of transitioning patients with RRMS from originator natalizumab (Tysabri) to a biosimilar version using a hypothetical payer with 1 million members, of whom 265 members were estimated to be treated with high-efficacy disease-modifying therapies for RRMS. The overall cost associated with transitioning to a natalizumab biosimilar was $102,061 in year 1, $156,354 in year 2, $202,804 in year 3. Cost savings per member amounted to $1180 in year 1, $1860 in year 2, and $2508 in year 3.

Reinvesting the generated savings would allow for 5 additional patients with RRMS to receive access to treatment.

References

1. Thunselle S, Redmond N, Gonikman A. Real-world infliximab biosimilar adoption strategy success in a commercially insured population of 1.6 million lives. Presented at: AMCP Nexus 2022; October 11-October 14, 2022; National Harbor, Maryland. Abstract K6.
2. Ko J, Mendelsohn A, Daniels K, et al. Patient characteristics and utilization for bevacizumab in ophthalmology and oncology in a distributed research network. Presented at: AMCP Nexus 2022; October 11-October 14, 2022; National Harbor, Maryland. Abstract H3.
3. Edward K, Goh A, Gupta S, Schauf M, Hartung D. Budget impact analysis of transitioning from reference to biosimilar natalizumab from a US payer perspective. Presented at: AMCP Nexus 2022; October 11-October 14, 2022; National Harbor, Maryland. Abstract G9.