Cost-Efficiency Modeling of Conversion to Biosimilar Rituximab-pvvr in Diffuse Large B-Cell Lymphoma 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 rituximab (Rituxan®), such as rituximab-pvvr (Ruxience®), can deliver substantial savings and/or expanded access to biologic therapies for patients with diffuse large B-cell lymphoma (DLBCL). The objective of this study is to explore the cost-efficiency and budget-neutral expanded access of rituximab-pvvr in DLBCL in Medicare.
METHODS: We developed a Medicare perspective simulation model of patients treated for DLBCL to estimate cost-savings from converting originator rituximab to rituximab-pvvr. The target Medicare patient population receiving first-line therapy for DLBCL (n=1,641) was calculated using Medicare enrollment data, SEER DLBCL incidence rates in age ≥65, and an assumption that 89.8% of new diagnoses would be eligible for rituximab-based treatment (Sineshaw et al. 2024) (n=1,473). We modeled combination therapy with R-CHOP. Costs were derived from 2024 Average Sales Price (ASP). Results include per-patient per-month (PPPM) cost savings (vs. originator), total monthly savings in the cohort, and the number needed to convert (NNC) to biosimilar to fund treatment of an additional 100 patients.
RESULTS: When setting the proportion of patients who used rituximab-pvvr over the originator to 50% (n=737) and 100% (n=1,473), the mean PPPM savings were $2,921 and $5,842, and full cohort monthly savings were $4,303,426 and $8,606,852, respectively. These savings represent 33% and 66% reductions in cost vs. originator-based treatment, respectively, and exceed savings from alternative biosimilars rituximab-abbs or -arrx. At 100% conversion, monthly savings could fund up to 2,900 additional patient-months of treatment with R-CHOP (using rituximab-pvvr). The NNC was 51 to treat an additional 100 patients with R-CHOP (using rituximab-pvvr) and ranged from 120-136 with alternative biosimilars.
CONCLUSIONS: We found that R-CHOP with rituximab-pvvr can achieve substantial cost savings relative to originator-based treatment, allowing reinvestment to treat a substantial number of additional patients with DLBCL, 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 DLBCL to estimate cost-savings from converting originator rituximab to rituximab-pvvr. The target Medicare patient population receiving first-line therapy for DLBCL (n=1,641) was calculated using Medicare enrollment data, SEER DLBCL incidence rates in age ≥65, and an assumption that 89.8% of new diagnoses would be eligible for rituximab-based treatment (Sineshaw et al. 2024) (n=1,473). We modeled combination therapy with R-CHOP. Costs were derived from 2024 Average Sales Price (ASP). Results include per-patient per-month (PPPM) cost savings (vs. originator), total monthly savings in the cohort, and the number needed to convert (NNC) to biosimilar to fund treatment of an additional 100 patients.
RESULTS: When setting the proportion of patients who used rituximab-pvvr over the originator to 50% (n=737) and 100% (n=1,473), the mean PPPM savings were $2,921 and $5,842, and full cohort monthly savings were $4,303,426 and $8,606,852, respectively. These savings represent 33% and 66% reductions in cost vs. originator-based treatment, respectively, and exceed savings from alternative biosimilars rituximab-abbs or -arrx. At 100% conversion, monthly savings could fund up to 2,900 additional patient-months of treatment with R-CHOP (using rituximab-pvvr). The NNC was 51 to treat an additional 100 patients with R-CHOP (using rituximab-pvvr) and ranged from 120-136 with alternative biosimilars.
CONCLUSIONS: We found that R-CHOP with rituximab-pvvr can achieve substantial cost savings relative to originator-based treatment, allowing reinvestment to treat a substantial number of additional patients with DLBCL, 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
EE473
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Oncology, STA: Biologics & Biosimilars