Cost-Efficiency Modeling of Conversion to Biosimilar Trastuzumab-qyyp in Early-Stage Breast Cancer in Medicare
Author(s)
Joshua A. Roth, MHA, PhD1, David Kratochvil, BS2, Stephanie Dorman, PhD1, Wenjie Zhang, PhD2;
1Pfizer, New York, NY, USA, 2OPEN Health, Bethesda, MD, USA
1Pfizer, New York, NY, USA, 2OPEN Health, Bethesda, MD, USA
OBJECTIVES: Biosimilars to originator trastuzumab (Herceptin®), such as trastuzumab-qyyp (Trazimera™), can deliver substantial savings and/or expanded access to biologic therapies for patients with early-stage breast cancer (BC). The objective of this study is to explore the cost-efficiency and budget-neutral expanded access of trastuzumab-qyyp in early-stage BC in Medicare.
METHODS: We developed a Medicare perspective simulation model of patients treated for early BC to estimate cost-savings from converting trastuzumab (originator) to trastuzumab-qyyp. The target patient population receiving first-line therapy for early-stage BC in Medicare (n=44,073) was calculated using Medicare enrollment data, SEER incidence for HER2-positive BC among those age ≥65, and an assumption that 14.0% of newly diagnosed cases are trastuzumab-eligible based on recent National Institute of Health (NIH) statistics (n=6,170). We modeled combination therapy with docetaxel, carboplatin, and trastuzumab (TCH), using costs derived from 2024 Average Sales Price (ASP). Results include per-patient per-month (PPPM) cost savings (vs. originator), total monthly cohort savings, and number needed to convert (NNC) to biosimilar to fund treatment of an additional 100 patients.
RESULTS: When setting the proportion of patients using trastuzumab-qyyp over the originator to 50% (n=3,085) and 100% (n=6,170), mean PPPM savings were $2,127 and $4,253, and full cohort monthly savings were $13,122,555 and $26,245,111, respectively. These savings represent 41% and 82% reductions in cost vs. originator-based treatment, respectively, and exceeded savings from alternative biosimilars trastuzumab-anns, -dttb, -pkrb, and -dkst. At 100% conversion, monthly savings could fund up to 28,285 additional patient-months of treatment with TCH (using trastuzumab-qyyp). The NNC was 22 to treat an additional 100 patients with TCH (using trastuzumab-qyyp) and ranged from 36-416 with alternative biosimilars.
CONCLUSIONS: TCH with trastuzumab-qyyp can achieve substantial cost savings relative to originator-based treatment, allowing reinvestment to treat a substantial number of additional patients with early-stage BC, or fund other costs of care in Medicare, on a budget-neutral basis.
METHODS: We developed a Medicare perspective simulation model of patients treated for early BC to estimate cost-savings from converting trastuzumab (originator) to trastuzumab-qyyp. The target patient population receiving first-line therapy for early-stage BC in Medicare (n=44,073) was calculated using Medicare enrollment data, SEER incidence for HER2-positive BC among those age ≥65, and an assumption that 14.0% of newly diagnosed cases are trastuzumab-eligible based on recent National Institute of Health (NIH) statistics (n=6,170). We modeled combination therapy with docetaxel, carboplatin, and trastuzumab (TCH), using costs derived from 2024 Average Sales Price (ASP). Results include per-patient per-month (PPPM) cost savings (vs. originator), total monthly cohort savings, and number needed to convert (NNC) to biosimilar to fund treatment of an additional 100 patients.
RESULTS: When setting the proportion of patients using trastuzumab-qyyp over the originator to 50% (n=3,085) and 100% (n=6,170), mean PPPM savings were $2,127 and $4,253, and full cohort monthly savings were $13,122,555 and $26,245,111, respectively. These savings represent 41% and 82% reductions in cost vs. originator-based treatment, respectively, and exceeded savings from alternative biosimilars trastuzumab-anns, -dttb, -pkrb, and -dkst. At 100% conversion, monthly savings could fund up to 28,285 additional patient-months of treatment with TCH (using trastuzumab-qyyp). The NNC was 22 to treat an additional 100 patients with TCH (using trastuzumab-qyyp) and ranged from 36-416 with alternative biosimilars.
CONCLUSIONS: TCH with trastuzumab-qyyp can achieve substantial cost savings relative to originator-based treatment, allowing reinvestment to treat a substantial number of additional patients with early-stage BC, or fund other costs of care in Medicare, on a budget-neutral basis.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE51
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Oncology, STA: Biologics & Biosimilars