Evaluation of real-world cost savings and utilization of biosimilar drugs in a community-based oncology practice.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 73-73
Author(s):  
Amit Sanyal ◽  
Michelle Schmitt ◽  
Daniel Wellner
Keyword(s):  
Real World ◽  
Reference Product ◽  
Cost Savings ◽  
The United States ◽  
Biosimilar Product ◽  
Community Based ◽  
Significant Cost ◽  
Clinically Significant ◽  
Oncology Practice ◽  
Practice Methods

73 Background: Biosimilar drugs, defined as biologic products with no clinically significant differences in quality, efficacy and safety compared to approved reference products have gained increasing adoption based on studies projecting significant cost savings[1]. Real world evaluation of biosimilar related cost savings and adoption is however still limited. We prospectively evaluate cost savings generated by transitioning to biosimilar monoclonal antibodies in a community based oncology practice. Methods: In July 2020, a process for transitioning patients to biosimilar equivalents of Rituximab, Trastuzumab and Bevacizumab was implemented in a community based oncology practice. Provider adoption was facilitated by monthly oncology pharmacy governance meetings that allowed provider participation and feedback followed by defaulting the preferred biosimilar product in oncology chemotherapy software (Epic Beacon, Epic Systems, Verona, WI). The treatment templates allowed for care personalization by listing reference products that could be chosen if desired. Cost savings achieved by switching to biosimilars was calculated by subtracting the actual spending on the biosimilar product from projected acquisition cost of the branded reference product (Table). Biosimilar adoption, defined as amount of biosimilar drug used over total amount of the drug ordered was also calculated. Results: Between July 2020 and April 2021, transitioning to biosimilar products for Rituximab, Bevacizumab and Trastuzumab resulted in net savings of $268,194.64, $285,251.89 and $274,359.51 respectively. Actual spending on Rituximab biosimilar product was $726,476.10 against a projected spending of $994,670.74 on the branded reference product. Actual spending on Bevacizumab biosimilar product was $1,254,977.30 against a projected spending of $1,540,229.19 on the branded reference product. Actual spending on Trastuzumab biosimilar product was $1,218,641.60 against a projected spending of $1,493,001.11 on the branded product. Average biosimilar utilization between October 2020 and April 2020 has been 92%, 100% and 98% for Rituximab, Bevacizumab and Trastuzumab respectively. Conclusions: Significant cost-savings can result from widespread utilization of biosimilar drugs in community oncology practices. References: Mulcahy, A.W., J.P. Hlavka, and S.R. Case, Biosimilar Cost Savings in the United States: Initial Experience and Future Potential. Rand Health Q, 2018. 7(4): p. 3.[Table: see text]

Real-world trends in biosimilar prescribing among oncology providers, 2019-2021.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18701-e18701
Author(s):  
Kelly A. McGlynn ◽  
Jacqueline McGarry ◽  
Kashyap B. Patel ◽  
Natasha Clinton
Keyword(s):  
Real World ◽  
Reference Product ◽  
The United States ◽  
Prescription Data ◽  
Nccn Guidelines ◽  
Prescribing Behavior ◽  
Product Pricing ◽  
Value Based Care ◽  
Oncology Providers ◽  
First 90 Days

e18701 Background: The number of approved biosimilars in the United States has increased exponentially in recent years. Within the oncology market, there are currently 14 approved biosimilars, with 11 launched since the start of 2019. The emergence of new oncology biosimilars provides a tool for success in value-based care, and has the potential to lower costs to patients and providers and expand access to care. Methods: Analysis of biosimilar prescribing behavior was performed using 2020 prescription data (Wolters Kluwer, n = 130,836), sales data (IQVIA), and dosage data for patients taking bevacizumab, trastuzumab, rituximab, or an FDA-approved biosimilar for these products (FDA Purple Book), between 2019-2021 (ION Solutions, n = 69,884). Drugs not directly interchangeable with the bevacizumab, trastuzumab or rituximab reference products according to NCCN guidelines were excluded. Results: Biosimilar products are currently available for bevacizumab (2 biosimilars), rituximab (3 biosimilars), and trastuzumab (5 biosimilars). We found that in 2020, 8.2% of new prescriptions for any of these three reference products were for a biosimilar. An analysis of real-world drug administration data revealed that in the 3 months following the 2019 launch of trastuzumab’s first biosimilar (trastuzumab-anns), 7.3% of initiating line 1 patients were prescribed the biosimilar over the reference product. During the same period in 2020, when a total of 5 trastuzumab biosimilars were available, 80.5% of initiating line 1 trastuzumab patients began treatment on a biosimilar, suggesting rapid uptake by providers. However, this differed by product, with the initial uptake for the first rituximab biosimilar (rituximab-pvvr), at only 2.3%. Uptake also occurred within treatment lines, with 11.1% of all patients (bevacizumab: 11.3%, trastuzumab: 14.1%, rituximab: 7.9%) switching from a reference product to a biosimilar during treatment. Uptake was particularly rapid for trastuzumab biosimilars: among patients on trastuzumab at the time of its first biosimilar launch, 18.2% switched to trastuzumab-anns in the first 90 days post-launch. Biosimilars launched at significantly lower prices than their reference products, with cost per prescription at -42.0%, -29.9% and -89.5% relative to the reference product for trastuzumab, rituximab and bevacizumab, respectively. However, biosimilar launches had little impact on reference product pricing, with 2019-2020 year-over-year (YOY) differences in price per prescription close to the YOY averages in previous years (2015-2019) for all three reference products. Conclusions: We conclude that uptake of biosimilars among oncology providers between 2019-2020 was rapid, although the extent of biosimilar prescribing varied among products. Biosimilars offered greatly reduced costs to providers, although reference product prices remained stable despite increased biosimilar competition.

scholarly journals Surgical instrumentation: the true cost of instrument trays and a potential strategy for optimization

2015 ◽  
Vol 4 (6) ◽  
pp. 82 ◽  
Author(s):  
Julie M. Mhlaba ◽  
Emily W. Stockert ◽  
Martin Coronel ◽  
Alexander J. Langerman
Keyword(s):  
United States ◽  
Cost Savings ◽  
Cost Effective ◽  
The United States ◽  
Waste Reduction ◽  
Significant Cost ◽  
Instrument Type ◽  
Hospital Revenue ◽  
Potential Strategy ◽  
The Cost

Objective: Operating rooms (OR) generate a large portion of hospital revenue and waste. Consequently, improving efficiency and reducing waste is a high priority. Our objective was to quantify waste associated with opened but unused instruments from trays and to compare this with the cost of individually wrapping instruments.Methods: Data was collected from June to November of 2013 in a 550-bed hospital in the United States. We recorded the instrument usage of two commonly-used trays for ten cases each. The time to decontaminate and reassemble instrument trays and peel packs was measured, and the cost to reprocess one instrument was calculated.Results: Average utilization was 14% for the Plastic Soft Tissue Tray and 29% for the Major Laparotomy Tray. Of 98 instruments in the Plastics tray (n = 10), 0% was used in all cases observed and 59% were used in no observed cases. Of 110 instruments in the Major Tray (n = 10), 0% was used in all cases observed and 25% were used in no observed cases. Average cost to reprocess one instrument was $0.34-$0.47 in a tray and $0.81-$0.84 in a peel pack, or individually-wrapped instrument.Conclusions: We estimate that the cost of peel packing an instrument is roughly two times the cost of tray packing. Therefore, it becomes more cost effective from a processing standpoint to package an instrument in a peel pack when there is less than a 42%-56% probability of use depending on instrument type. This study demonstrates an opportunity for reorganization of instrument delivery that could result in a significant cost-savings and waste reduction.

scholarly journals PROTOTYPE EXPERIENCE WITH RUBBLE MOUND BREAKWATERS

1986 ◽  
Vol 1 (20) ◽  
pp. 153
Author(s):  
K.J. MacIntosh ◽  
W.F. Baird
Keyword(s):  
United States ◽  
Cost Savings ◽  
The United States ◽  
Cost Structure ◽  
Simple Construction ◽  
Significant Cost ◽  
Prototype Experience ◽  
Rubble Mound ◽  
The Cost ◽  
Rubble Mound Breakwaters

At the 19th ICE Conference in Houston in 1984 an alternative concept for the design of rubble mound breakwaters was introduced. This concept has the objective of providing a least cost structure by optimizing the use of locally available materials and utilizing simple construction procedures. Contractors' bids demonstrated that significant cost savings could be achieved, when compared to the cost of traditional designs. Considerable prototype experience has now been obtained with this concept of breakwaters. Breakwaters have been built using the concept in Canada, the United States, and Iceland since 1984 and have been subjected to storms and ice action. Prototype observations have supported the performance predicted during the design process. In this paper surveys of a breakwater taken after construction and after storm action are presented. In addition to wave action, this breakwater has also been subjected to extensive ice action. The response of the breakwater has been monitored and observed and is discussed.

scholarly journals Real-world use and acceptance of biosimilar monoclonal antibodies of rituximab in oncology practice in the USA

2021 ◽  
Author(s):  
Ahmed Shelbaya ◽  
John M Kelton ◽  
Jeffrey Thompson ◽  
Jose MJ Alvir ◽  
Martine C Maculaitis ◽  
...  
Keyword(s):  
Chronic Lymphocytic Leukemia ◽  
Real World ◽  
Hodgkin’S Lymphoma ◽  
Reference Product ◽  
Lymphocytic Leukemia ◽  
Hodgkin's Lymphoma ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma ◽  
The Usa ◽  
Oncology Practice

Aim: To describe treatment patterns and patient and provider characteristics associated with the recently introduced biosimilar rituximab-pvvr. Methods: This retrospective analysis included adult patients with one or more claims for rituximab-pvvr, with an index date of 23 January 2020 and a study period covering 1 January 2019–31 July 2020. Results: Of 249 patients included, the most common rituximab-pvvr indications were non-Hodgkin’s lymphoma (77.5%) and chronic lymphocytic leukemia (11.2%). Some patients with non-Hodgkin’s lymphoma (42.5%) and chronic lymphocytic leukemia (39.3%) switched to rituximab-pvvr from the reference product or another rituximab biosimilar. Most patients were aged ≥65 years (63.5%) and were male (54.6%). Most (59.0%) rituximab-pvvr prescribers practiced in the south of the USA. Conclusion: Utilization occurred in approved and extrapolated indications. These preliminary findings suggest switching between reference product and rituximab biosimilars; rituximab-pvvr combination regimens are being adopted in real-world oncology practice.

Initial experience of patients treated in a real-world clinical setting with bevacizumab-awwb: The first FDA-approved biosimilar to bevacizumab.

2021 ◽  
Vol 39 (3_suppl) ◽  
pp. 81-81
Author(s):  
Ran Jin ◽  
Neil A Accortt ◽  
Darcie Sandschafer ◽  
Tatiana Lawrence ◽  
Arturo Loaiza-Bonilla
Keyword(s):  
Real World ◽  
Clinical Characteristics ◽  
Reference Product ◽  
Previous Treatment ◽  
The United States ◽  
Product Launch ◽  
Cancer Management ◽  
Level Data ◽  
Nsclc Patients ◽  
Tumor Types

81 Background: Bevacizumab-awwb is the first anti-cancer biosimilar and the first biosimilar to bevacizumab approved by the FDA. It was launched in the United States on July 19, 2019. Bevacizumab-awwb approval was based on a phase 3 study in a pre-determined sensitive population of non-squamous non-small cell lung cancer (NSCLC) patients. This study investigated initial use of bevacizumab-awwb, across its approved indications for advanced cancer management, in real-world US community and academic oncology practices. Methods: This retrospective observational study described demographic and clinical characteristics of patients who received bevacizumab-awwb using structured patient-level data from the nationwide de-identified Oncology Services Comprehensive Electronic Records (OSCER), a Flatiron Health EHR-derived database. The database is longitudinal, demographically and geographically diverse, and includes more than 2.2 million US cancer patients from >280 cancer clinics. This analysis included adult patients who received ≥1 bevacizumab-awwb infusion between July 30, 2019 and April 30, 2020 and focused on describing initial biosimilar uptake in cancer patient populations beyond NSCLC. Results: First use of bevacizumab-awwb was in mCRC and occurred within 10 days of product launch. All bevacizumab-awwb approved cancer indications were represented among 2,422 patients treated with bevacizumab-awwb. Initial use of bevacizumab-awwb across indications: mCRC (68%), NSCLC (14%), brain cancer (11%), cervical cancer (5%), metastatic renal cell carcinoma (1%). Among 1657 mCRC patients treated with bevacizumab-awwb, 55% were male with a median age of 65 years (y). Most patients were white (60%), with ECOG scores of 0/1 (84%), and median body weight was 78 kg. Among mCRC patients, 59% had received the reference product before receiving the biosimilar. Among patients with other tumor types, 42-50% had prior bevacizumab exposure. Among mCRC patients with prior exposure to bevacizumab, 67% received bevacizumab-awwb within 28 days of last infusion of reference product (Table). Demographic and clinical characteristics were comparable between patients with and without prior bevacizumab use. Conclusions: Early evidence suggests physicians are comfortable initiating or transitioning patients to the first FDA-approved biosimilar to bevacizumab, with little evidence that demographic characteristics differ between patients with and without previous treatment with bevacizumab. Future analyses will determine whether these patterns persist across all indications. [Table: see text]

scholarly journals TRANSPORTATION ROUTES FOR LATIN AMERICAN PRODUCE IMPORTS INTO THE UNITED STATES

HortScience ◽  
1992 ◽  
Vol 27 (6) ◽  
pp. 609a-609
Author(s):  
David H. Picha ◽  
Roger A. Hinson
Keyword(s):  
Latin American ◽  
Fruits And Vegetables ◽  
Cost Savings ◽  
The United States ◽  
South Florida ◽  
Central American ◽  
South American ◽  
Significant Cost ◽  
Trade Routes ◽  
Transportation Routes

The origin and distribution of counter-seasonal fresh fruit and vegetable imports from Latin America into the U.S. was evaluated. Infrastructure comparisons were made among various U.S. ports of entry capable of receiving perishables. Economic comparisons were made utilizing different transportation routes. Market boundary analyses indicated significant cost savings would result from changing existing transportation routes to certain final U.S. destinations. Currently the port of Philadelphia receives the majority of South American fruit which is mostly shipped break bulk or palletized. South Florida ports (Miami and Port Everglades) receive the majority of Central American and Caribbean fruits and vegetables which are mostly shipped containerized. Interest exists among Latin American exporters to diversify their U.S. ports of entry in order to avoid distribution bottlenecks. Future trade routes will likely see an increased utilization of more economical U.S. Gulf of Mexico ports.

scholarly journals Real-World Treatment Patterns and Characteristics Among Patients with Agitation and Dementia in the United States: Findings from a Large, Observational, Retrospective Chart Review

2020 ◽  
Vol 77 (3) ◽  
pp. 1181-1194
Author(s):  
Myrlene Sanon Aigbogun ◽  
Martin Cloutier ◽  
Marjolaine Gauthier-Loiselle ◽  
Annie Guerin ◽  
Martin Ladouceur ◽  
...  
Keyword(s):  
United States ◽  
Residential Care ◽  
Real World ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
The United States ◽  
Pharmacological Therapy ◽  
Treatment Patterns ◽  
First Line ◽  
Community Based

Background: Few studies have examined patient characteristics and treatment patterns among patients with dementia and agitation in the United States (US). Objective: To examine real-world treatment patterns and characteristics of patients with agitation related to dementia who were treated with antipsychotics in US residential care and community-based settings. Methods: This retrospective chart review collected US physician-level data from patients 55 to 90 years old initiated on an antipsychotic medication for the treatment of agitation related to dementia from January 2018 to May 2018. Clinical characteristics and treatment patterns were assessed overall and stratified by residential care and community-based settings. Results: A total of 313 participating physicians, 59.5% of whom were primary care physicians, abstracted 801 patient charts (residential care: n = 312; community-based: n = 489). Of patients with agitation who were initiated on an antipsychotic, most patients (74.5%) were initiated within 3 months of the onset of their studied agitation episode, and 62.8% experienced multiple agitation episodes before initiation. While non-pharmacological therapies are recommended first-line approach for agitation in dementia, use of non-pharmacological therapy before initiation of antipsychotics was reported for only 37.8% of patients in residential care and 21.3% in community-based settings. Conclusion: Most patients were initiated on an antipsychotic treatment after multiple episodes of agitation and largely without initial non-pharmacological therapy, suggesting that current treatment guideline recommendations for first-line non-pharmacological intervention may not be adequately followed in clinical practice. Understanding the clinical burden and treatment patterns among dementia patients with agitation is imperative for effective disease management.

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