In a recent publication in Journal of Clinical Oncology, researchers sought to investigate the correlation of time, practice type, and payment source with regard to the use of oncology biosimilars in the United States from 2019 to 2021.

The authors wrote, "Biosimilars have been introduced into guidelines from ASCO [American Society of Clinical Oncology] and other professional organizations as equally safe and effective agents for the treatment and supportive care of patients with cancer."

From 2019 to 2021, researchers obtained biologic utilization data from 38 practices participating in PracticeNET—ASCO's business benchmarking program—which provides data and analysis to oncology practices in all settings to promote improvements in patient care and enhance business operations.

The researchers focused on data from specific originator biologics commonly prescribed in oncology practice. Practices were classified as either physician (i.e., independent physician practice) or hospital, representing hospital-based health systems and their associated cancer centers.

The researchers completed the quantitative analysis with a survey of PracticeNET participants, including prescribers and practice leaders, to discover possible influences and barriers to biosimilar use. They also employed logistic regression to assess the biosimilar use for each biologic, with covariates including time, practice type, and payment source and reported on several groups of practices.

The results revealed that over the 3-year study period, biosimilar use expanded and, depending upon the biologic, reached between 51% and 80% of administered doses by the fourth quarter of 2021. The average cost per dose diminished between 24% and 41%, depending on the biologic.

Additionally, between January 2019 and December 2021, the average Medicare payment limit (MPL) per dose of all administered originator and biosimilar products decreased. For example, the MPL for bevacizumab decreased from $4,568.86 to $2,918.26, representing a 36% decrease; for rituximab from $5,572.37 to $3,809.66, a 32% decrease; and trastuzumab from $4,702.67 to $2,851.45, a 39% decrease. The researchers indicated that the price reduction was the result of the introduction of lower cost biosimilars, as well as reducing trends in prices of the originator and available biosimilars.

The researchers also indicated that the use of biosimilars differed by practice, with independent physician practices reporting higher use of biosimilars, and compared with commercial health plans, Medicaid plans had lower biosimilar use for four biologics; traditional Medicare had lower use for five biologics.

The authors indicated that the use of biosimilars has expanded and decreased the average cost per dose of the examined biologics. Additionally, the use of biosimilars varied by originator biologic, practice type, and payment source, and there are numerous opportunities to implement measures to expand the use of biosimilars among certain practices and payers.

Based on their findings, the authors indicated that to promote the safe and extensive implementation of biosimilars into clinical practice, they recommended continuing research efforts to employ real-world, postmarket evidence to demonstrate the safety, effectiveness, and value of each unique biosimilar product.

The authors added, "As patients with cancer pursue treatment, improving access to biosimilar drug information and education as well as transparency regarding treatment regimens will be essential to maintain the trust within a patient-physician relationship."

In conclusion, the authors wrote, "The findings from this study support ASCO's acknowledgment that the use of biosimilars might provide competitive, lower-cost alternatives to biologics used in cancer care; however, frequent changes in price, reimbursement, and payer policies may prevent practices from maximizing biosimilar use and place practices at financial risk of purchasing a biosimilar that may later not be adequately reimbursed."

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