Biosimilars Cut Cancer Drug Costs by $3,820 Monthly for Insurers, UCLA Study Finds
核心洞察
A UCLA Health Jonsson Comprehensive Cancer Center (搜索) study found cancer patients exclusively using biosimilars had monthly insurer costs $3,820 lower than those using originator biologics.
Patients using biosimilars also saved $39.50 per month in out-of-pocket costs compared with those using branded biologic drugs.
Biosimilar entry was associated with a 3.8% annual decline in originator prices and roughly 30% annual market share loss among commercially insured patients.
Cancer patients who exclusively used biosimilars had average monthly costs that were $3,820 lower for insurers and $39.50 lower out of pocket compared with patients who exclusively used the original branded biologic drugs, according to a new study led by researchers at the UCLA Health Jonsson Comprehensive Cancer Center (搜索). The findings, published in JAMA Oncology, provide evidence that market competition enabled by the entry of biosimilars may help reduce the cost of cancer biologic drugs.
The study examined the economic impact of biosimilar use in real-world cancer care, addressing a gap in understanding of how biosimilar entry across three major cancer biologics affected prices, market share, and ultimately costs for insurers and patients.
Why Biosimilar Competition Matters
Cancer treatment can place a significant financial burden on patients, with financial hardship associated with medication nonadherence and poorer health outcomes. The high and rising cost of anticancer medications, particularly biologic drugs, which are complex medicines made using living cells, is one contributor to this burden. Previous research has estimated that financial toxicity may affect as many as half of patients with cancer in the United States.
Biosimilars were introduced as one potential way to address the high cost of biologic medicines. Unlike generic versions of conventional drugs, biosimilars are highly similar to, but not identical to, their originator products and have no clinically meaningful differences from them. A federal policy enacted in 2009 was designed to establish an abbreviated regulatory pathway for biosimilars in the U.S. market to increase competition, lower prices and improve access to biologic treatments. By the end of 2024, 13 biosimilars were available for three major cancer biologics: bevacizumab, rituximab and trastuzumab. These drugs are used to treat cancers including breast cancer (搜索), lymphoma (搜索), colorectal cancer (搜索), lung cancer (搜索) and ovarian cancer (搜索).
Study Design and Patient Population
Researchers conducted a retrospective cohort study using health insurance claims data to examine the use and costs of three cancer biologics after biosimilars became available for each. They analyzed data from 14,655 patient-drug pairs involving people with cancer who initiated bevacizumab, rituximab or trastuzumab between 2020 and 2023. The study included patients with commercial insurance and Medicare-related coverage and tracked their treatment and costs for 12 months after they began treatment with a biologic.
The researchers grouped patients based on whether they exclusively used a biosimilar, exclusively used the originator, switched from the originator to a biosimilar, or switched from a biosimilar to the originator. They compared monthly costs paid by insurers and patients' out-of-pocket payment, calculated as the sum of deductibles, copayments and coinsurance. They also examined changes in the average sales price and market share of the originators and their biosimilars from before biosimilar entry through 2024 to assess how the introduction of biosimilars affected market dynamics.
Key Findings on Cost Savings
Among the patient-drug pairs, 59.4% of patients exclusively used a biosimilar during the first 12 months of treatment, while 32.5% exclusively used the originator. About 6.9% of patients switched from the originator to a biosimilar, and 1.2% switched from a biosimilar to the originator. This suggests that biosimilars were adopted primarily by patients starting treatment rather than through switching patients who were already receiving the originator.
Patients who exclusively used biosimilars were associated with substantially lower monthly costs for insurers. After adjusting for differences among patients and treatment patterns, average monthly payer costs were $8,959 for patients who exclusively used biosimilars, compared with $12,779 for those who exclusively used the originator, a difference of $3,820 per month. Patients who exclusively used biosimilars also had lower average monthly out-of-pocket costs, $118.90 compared with $158.40 for those who exclusively used the originator, a savings of $39.50 per month.
Market Dynamics After Biosimilar Entry
The researchers also found that biosimilar entry was associated with lower prices and declining market share for the originators. The average sales price of the three originators declined by 3.8% per year after biosimilars entered the market, while their market share decreased by about 30% annually among patients with commercial insurance and 31.5% in Medicare Part B. The average sales price of the 12 biosimilars included in the study declined by 12.4% per year.
Implications for Patients and Providers
The findings suggest that biosimilars could help reduce some of the financial burden associated with cancer treatment for patients while creating savings for the healthcare system. Although the savings were substantially greater for insurers than for patients, even modest reductions in out-of-pocket costs may be meaningful for people facing the financial challenges of cancer care, savings that can be used toward other treatment-related expenses or cover living expenses.
The study also points to treatment initiation as an important opportunity to expand biosimilar use. Because most patients in the study who received biosimilars started treatment with them, rather than switching from an original biologic, decisions about which drug to use when treatment begins may play an important role in increasing access to lower-cost and equally efficacious alternatives.
"The FDA has continued to take regulatory actions aimed at further unlocking biosimilar competition recently," said Xiaoyu Liu, PhD, first author of this study. "Our study findings offered further evidence to support patients, providers and insurers in their consideration of biosimilars."
Tina Shih, PhD, director of the Cancer Health Economics Research Program at UCLA Health Jonsson Comprehensive Cancer Center (搜索), professor of Health Economics in the Department of Radiation Oncology, served as senior author of the study.