In a multicenter, retrospective cohort study published in the Journal of Oncology Pharmacy Practice, researchers sought to evaluate the cost savings of combining dose-rounding strategies (DRS) with biosimilar use (BU).

The researchers wrote, “The exponential rise in cancer costs has led many centers to utilize dose rounding to the nearest vial size when the difference in dose is ≤10% to decrease costs. The recent approval of several biosimilar products has presented another opportunity to mitigate the rising costs of oncology care. Scarce information exists about the expected cost savings of combining dose rounding strategies (DRS) with biosimilar use (BU).”

From October 1, 2015, to September 1, 2020, researchers gathered electronic health record data from two health systems in Rhode Island involving patients who received ≥1 dose of trastuzumab, a trastuzumab-biosimilar, bevacizumab, or a bevacizumab biosimilar.

The researchers used Medicare drug pricing to estimate costs. Costs per dose between the four exposure groups (DRS + BU, DRS only, BU only, and neither DRS nor BU) were compared using multivariable generalized estimating equations adjusted for age, gender, presence of metastases, dosing weight, and dose administered.

The researchers obtained data from 1,156 patients who were administered 15,145 doses of drug. The results revealed that savings in the dose-rounded biosimilar group were greater than for using either strategy, combined.

Based on their findings, the authors wrote, “We found that they saved hundreds of dollars in drug costs per dose. We observed when adjusting for covariates, dose-rounded biosimilars were $331 and $497 less on average per dose for trastuzumab and bevacizumab, respectively. This finding was consistent for both monoclonal antibodies. Combining both cost-saving tactics is an optimal strategy to mitigate the high prices of cancer treatments.”

The authors concluded that combining dose rounding and biosimilar use resulted in meaningful cost savings per dose and that their policy of combining dose rounding and biosimilars is an effective approach resulting in substantial overall cost savings.

The researchers stated, “This strategy should be considered for global adaptation as standard to circumvent rising costs, as this initiative allows for cost avoidance without compromising care.”

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