Uptake of oncology-related biosimilars: a global analysis of usage data

Biologics have greatly improved cancer management but are costly. Biosimilars cost less and have no clinically meaningful differences compared with reference products. However, they are not identical, leading to hesitation among clinicians and patients to use them. The objective of this study is to measure the uptake of oncology-related biosimilars versus reference products in the United States and countries with similar regulatory frameworks.

We conducted a cross-sectional sales analysis from 13 countries between October 2022 and September 2023 for 5 oncology-related biologics with biosimilars: bevacizumab, filgrastim, pegfilgrastim, rituximab, and trastuzumab. We used IQVIA MIDAS® data on country-level quarterly sales volume and value.

Among the 13 countries, the United States ranked 10th in the proportion of oncology-related biosimilar uptake by units sold (75% vs median 86%) and spending (58% vs 76%). Biosimilar uptake in the United States was 84% for filgrastim (vs 95%), 83% for bevacizumab (vs 86%), 75% for rituximab (vs 93%), 70% for trastuzumab (vs 70%), and 44% for pegfilgrastim (vs 83%). The United States spent USD $8.4 billion on these biologics during the study period. European countries including Norway, Italy, and Sweden had the highest uptake, whereas New Zealand, Japan, and Belgium had the lowest. Across countries, biosimilar filgrastim had the highest uptake (95% of units) and trastuzumab the lowest (70%).

Oncology-related biosimilar uptake in the United States was below average among included countries. Increasing biosimilar uptake may reduce spending, and savings can be reinvested into cancer care. Future research on time trends can help assess barriers and enablers of biosimilar uptake across countries.