In a publication in Journal of Clinical Oncology: Oncology Practice, researchers conducted a study to verify and quantify the real-world cost-savings of two of the earliest bevacizumab biosimilars, including Zirabev (bevacizumab-bvzr; Pfizer) approved for the first-line treatment of metastatic colorectal cancer (mCRC) relative to originator Avastin (bevacizumab) for patients with mCRC.

The authors wrote, “While the introduction of biosimilars present an opportunity to alleviate the financial toxicity owing to the escalating costs of novel biologics, biosimilars should be comparatively assessed against the reference biologic in a real-world setting to confirm that they are indeed cost-saving or cost-effective after implementation.”

The researchers conducted a population-based, retrospective cohort study in Ontario, Canada, where originator and biosimilar bevacizumab are universally publicly funded. Utilizing the entire population of Ontario, the researchers assessed all patients diagnosed with mCRC patients who received reference bevacizumab between January 1, 2008, and August 11, 2019, or biosimilar bevacizumab between August 12, 2019, and March 31, 2021.

To adjust for differences at baseline, biosimilar cases and reference bevacizumab controls were matched 1:4 utilizing propensity-score methods. The researchers then calculated 1-year total patient-level costs (in Canadian dollars) and effects (in life years and quality-adjusted life years [QALY]) from the public health payer’s perspective.

“The primary outcomes for estimating cost-effectiveness included incremental net monetary benefit (INMB) and incremental net health benefit (INHB), calculated at willingness-to-pay (WTP) thresholds ranging from $50,000-200,000 per life year gained. Sensitivity analyses included a subgroup analysis by biosimilar type (MVASI/Zirabev) and an analysis using a 2-year time horizon.”

The authors noted that the final propensity score–matched cohort included 747 biosimilar cases and 2,945 controls, and the use of bevacizumab biosimilars was correlated with an incremental cost of –$6,379 (95% CI; –9,417, –3,537; i.e., cost-saving) and an incremental effect of 0.0 (95% CI; –0.02, 0.02) life years gained and –0.01 (95% CI; –0.03, 0) QALY gained.

They also indicated that the INMB and INHB estimates showed that biosimilar bevacizumab is cost-effective at all WTP thresholds reviewed, with results staying constant across the biosimilar type subgroups and 2-year sensitivity analyses.

Based on their findings, the authors concluded that using bevacizumab biosimilars demonstrated real-world cost-savings while providing comparable survival benefit as the originator bevacizumab, therefore validating the initial projections of their implementation.

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