In a recent publication in Journal of Clinical Oncology, researchers conducted a study to evaluate trastuzumab to identify how trends in the price and treatment cost of the originator brand and biosimilar forms of trastuzumab have changed since the availability of the biosimilar for the treatment of human epidermal growth factor receptor 2–positive breast cancer.

The researchers indicated, "We use average sales price data from the Centers for Medicare and Medicaid Services, adjusted for inflation to real 2020 dollars using the consumer price index, to describe price changes for the originator biologic and biosimilar versions of trastuzumab between 2019, when the first biosimilar was covered by Medicare, and 2022 when a total of five biosimilar competitors were on the market." They also noted that from 2005 to 2022, they estimated total treatment costs of biologic and biosimilar forms of trastuzumab and expressed changes in their market share.

The results revealed that the first biosimilar entrant's price was 15% lower than the originator brand in 2019. In 2022, the fifth biosimilar entrant's price was 58% lower than the originator brand in 2019.

The researchers wrote, "Contrary to expectations from prior research, the originator biologic price in 2022 decreased 29% from its 2019 average sales price. The average treatment cost for the biologic and biosimilar versions of trastuzumab combined was $45,659 US dollars lower in 2022 compared with the year before biosimilar entry, 2018. Finally, biosimilar market share grew from only 7% in the first year of entry to 32% in the second year, when three biosimilars were on the market."

Based on their findings, the authors stated, "Our findings suggest that policies that remove barriers to biosimilar entry and encourage biosimilar use can increase price competition in specialty pharmaceutical markets and reduce treatment cost. Education is also needed to demonstrate to both providers and patients that biosimilars are not less effective."

The authors concluded that the entry of biosimilars in the market may successfully reduce the cost associated with biologic oncology treatments, expand patient access to valuable therapies, and at the same time diminish healthcare costs while also enhancing the health-related quality of life for patients with cancer who need these life-saving drugs.

With regard to real-life clinical application, the authors wrote, "We find that biosimilar entry is associated with significant reductions in the price of biologic treatments. This is particularly important as novel, high-cost drugs that are alternatives to trastuzumab or are indicated for use with trastuzumab enter the market. Notably, many fee-for-service Medicare beneficiaries face an uncapped 20% coinsurance payment for infused cancer drugs–including trastuzumab. Switching from the brand-name to the least expensive biosimilar form of trastuzumab would reduce beneficiary out-of-pocket spending significantly."

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