Since the first filgrastim biosimilar was approved in 2008, there is now five years of data on which to assess the efficacy, safety and cost-effectiveness of biosimilar granulocyte colony-stimulating factors (G-CSFs). A pooled analysis of post-approval studies of one of the most common biosimilar G-CSFs, Zarzio (filgrastim), is presented by Pere Gascón and co-authors [1]. Their findings highlight significant cost savings in health authority regions that have switched from the originator G-CSF to its biosimilar Zarzio. The study overturns early concerns that cost savings would not be so great as hoped [2].
Although the authors highlight the financial benefits of switching to the biosimilar, they also stress the importance of identifying specific products by brand name. Biosimilars are not identical to their originator products, but this could be overlooked by relying on International Nonproprietary Names (INNs), which are shared with originators. All biosimilar G-CSFs, and their originator, share the INN filgrastim. Relying on the INN would make accurate pharmacovigilance impossible. In response, the European Organisation for Research and Treatment of Cancer (EORTC) guidelines [3] highlight the need for clinicians to identify specific products, such as Zarzio, by brand name to reduce the incidence of side effects. The guidelines also state that pharmacists should not switch biosimilar brands without informing both physician and patient.
Once these safeguards are in place, and given the safety and efficacy of Zarzio, there are significant cost savings to be made. In London, UK, for example, switching from the originator to Zarzio was associated with an annual saving of GBP 1 million, which was predicted to rise as more patients were switched to Zarzio. In Sweden’s Southern Health Care region, the introduction of biosimilar G-CSF was associated with net savings of Euros 2 million, a saving of 4-5% of the total drug budget.
In both these examples, the reduced costs appear to have improved patient access to G-CSF. In the UK, for example, the availability of biosimilar G-CSF in September 2008 resulted in a 13% increase in overall G-CSF use in the first year and a further 17% increase the following year. Alongside this, write Gascón and co-authors, cost savings could be redistributed, improving access to new cancer treatments, and reducing cost saving pressures elsewhere.
In the current financial climate, conclude the authors, biosimilars offer an affordable, safe and effective alternative. ‘Increasing adoption of biosimilars should help reduce healthcare budgets and improve access to expensive biological treatments,’ they conclude.
Conflict of interest
Several of the authors of the research paper [1] reported conflicts of interest, including having received honoraria from Sandoz for speaking at educational events, congress presentations and attending advisory boards. For more details, see [1].
Editor’s comment
Readers interested to learn more about possible cost savings to be made with the use of biosimilars are invited to view the following manuscript published in GaBI Journal:
Saving money in the European healthcare systems with biosimilars
If you are interested in contributing a research paper in a similar area to GaBI Journal, please send us your submission here.
Related article
How safe is Zarzio after five years’ clinical experience?
References
1. Gascón P, et al. Clinical experience with Zarzio® in Europe: what have we learned? Support Care Cancer. 2013;21(10):2925-32.
2. Olry de Labry A, et al. Biosimilars in the European market. Generics and Biosimilars Initiative Journal (GaBI Journal). 2013;2(1):30-5. doi: 10.5639/gabij.2013.0201.012
3. EORTC continues to support the appropriate treatment of adult patients with G-CSF to prevent febrile neutropenia: guideline updates. Generics and Biosimilars Initiative Journal (GaBI Journal). 2013;2(1):47-8. doi:10.5639/gabij.2013.0201.016
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