A budget impact model for biosimilar myeloid growth factors (MGFs) within the Oncology Care Model (OCM): An oncology group practice perspective.

Authors

null

Ali McBride

University of Arizona Cancer Center, Tucson, AZ

Ali McBride, Weijia Wang, Edward C. Li, Sanjeev Balu, Kim Campbell

Organizations

University of Arizona Cancer Center, Tucson, AZ, Sandoz Inc., Princeton, NJ

Research Funding

Pharmaceutical/Biotech Company
Sandoz.

Background: Value-based programs, such as the OCM, provide incentives for healthcare providers to lower costs and improve patient outcomes. Use of biosimilar vs. reference MGFs for febrile neutropenia (FN) prophylaxis (Px) has been suggested as one strategy to help practices meet these goals. The purpose of this study is to quantify the potential impact of using biosimilar MGFs on OCM metrics from a US practice perspective. Methods: The budgetary impact of two scenarios of MGF Px for a hypothetical panel of 500 patients in 1 year receiving 6 cycles of FN-risk stratified chemotherapy (CT) was assessed; model inputs for the rates of MGF Px based on FN risk were estimated from the literature. The first scenario compares the projected 1-year total (i.e., drug and administration) costs of using LA-EP2006 (a proposed Sandoz pegfilgrastim biosimilar) vs. reference pegfilgrastim, assuming the same MGF utilization rate within the 500 patients. The second scenario evaluates the cost implications of expanding access to LA-EP2006 for 10% more patients receiving intermediate-FN risk CT and the subsequent impact on MGF costs and FN-related healthcare utilization costs (e.g., emergency visits, hospitalizations, outpatient management). MGF costs were derived from publically available data; healthcare resource utilization and costs were estimated from the literature. Results: For 500 patients receiving CT, 107 were estimated to receive MGF Px, resulting in total costs of $3.02 million (M) for reference pegfilgrastim and $2.42 M for LA-EP2006 with $1.05 M in FN-related healthcare utilization costs. If MGF access (using LA-EP2006) were expanded to 10% more patients receiving intermediate-FN risk CT, 129 patients would receive MGF Px at a cost of $2.91 M; FN-related healthcare costs would decrease by $27,155. Conclusions: Using biosimilar vs. reference pegfilgrastim can help OCM-participating practices reduce their drug costs. Potentially, a practice can address an existing gap in FN prevention by expanding biosimilar MGF access for patients receiving intermediate-FN risk CT, which may help to meet OCM metrics such as reducing hospitalizations and emergency visits.

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Abstract Details

Meeting

2019 ASCO Quality Care Symposium

Session Type

Poster Session

Session Title

Poster Session A: Cost, Value, and Policy; Health Equity and Disparities

Track

Cost, Value, and Policy,Health Care Access, Equity, and Disparities

Sub Track

Value/Cost of Care

Citation

J Clin Oncol 37, 2019 (suppl 27; abstr 108)

DOI

10.1200/JCO.2019.37.27_suppl.108

Abstract #

108

Poster Bd #

H7

Abstract Disclosures

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