A Health Technology Assessment of a Proposed Biosimilar for the Treatment of Chemotherapy Induced Febrile Neutropenia: A U.S. Payer Perspective
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Issue Date
2013
Authors
Vaidya, Neel '13
Degree
MS in Health Outcomes Research
Advisor
Cosler, Leon E
Committee Members
Polimeni, John
Chandrasekara, Ray
Chandrasekara, Ray
Journal Title
Journal ISSN
Volume Title
Abstract
The goal of this comparative technology assessment was to estimate the economic value as well as clinical value of a proposed biosimilar from a US payer perspective. The biosimilar is compared to filgrastim and pegfilgrastim, intended for the treatment of chemotherapy induced febrile neutropenia (CIN). A decision analytical model was designed and implemented using TreeAge Pro 2013 software. The initial cost and clinical estimates were based on similar model published by Eldar-Lissai (2008). The model was modified to include a proposed biosimilar expected to be released in the U.S. in 2014. Modified and updated clinical and cost estimates were input into the model and costs were adjusted for 2013 using the CPI for medical care. Costs and outcomes were estimated for a time horizon of one chemotherapy cycle. Sensitivity analyses, including Monte Carlo probabilistic analyses, were conducted to assess the robustness of the model. The model estimated expected costs for the three therapies to be: $3,092.41, $3,808.81, and $5,238.82 for biosimilar filgrastim, originator filgrastim, and pegfilgrastim respectively. A tornado sensitivity diagram identified the most critical assumptions in the model were the number of biosimilar injections; and the per-dose cost of the biosimilar. The estimated savings of the biosimilar is estimated to be $716.40 per chemotherapy cycle. Based on estimated usage, this translates to a total potential savings of $1.2 billion by the end of 2014. Length of hospital was also estimated for each treatment option which allows for the calculation of an incremental cost-effectiveness ratio (ICER). The cost-effectiveness analysis resulted in an ICER of $ -3,766.29/day length of stay between pegfilgrastim and biosimilar filgrastim. With new U.S. legislation and filgrastim losing its patent protection in December 2013, this pharmacoeconomic analysis is timely and significant. This research highlights significant economic savings of a proposed biosimilar compared to filgrastim but also showed evidence of clinical value compared to pegfilgrastim.
Citation
Vaidya, Neel. "A Health Technology Assessment of a Proposed Biosimilar for the Treatment of Chemotherapy Induced Febrile Neutropenia : A U.S. Payer Perspective." Albany College of Pharmacy and Health Sciences, New York, Proquest/UMI, 2013.
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