Cost-efficiency modeling of conversion to biosimilar rituximab-based R-CHOP in diffuse large B-cell lymphoma in...

Area of Science:

• Oncology
• Pharmacoeconomics
• Health Policy

Background:

• Biosimilar rituximab products (Ruxience, Truxima, Riabni) are FDA-approved alternatives to originator rituximab (Rituxan).
• These therapies are indicated for diffuse large B-cell lymphoma (DLBCL) in combination with CHOP chemotherapy.
• Medicare's cost-efficiency for biosimilar rituximab conversion in DLBCL treatment is under investigation.

Purpose of the Study:

• To evaluate the cost-efficiency of converting Medicare patients with DLBCL from originator rituximab to biosimilar rituximab-based R-CHOP therapy.
• To explore the potential for budget-neutral expanded access to DLBCL treatment through biosimilar adoption.

Main Methods:

• A simulation model was developed from a Medicare perspective for DLBCL patients.
• The model estimated cost savings from converting to biosimilar rituximab (rituximab-pvvr, -abbs, -arrx) versus originator rituximab.
• Patient population data from Medicare enrollment and SEER cancer incidence rates were used, with costs from 2025 ASP files.

Main Results:

• 100% biosimilar conversion yielded per-patient per-month (PPPM) savings of $4,638, with total monthly savings of $22.1 million for the Medicare cohort (n=4,772).
• The number needed to convert (NNC) to fund 100 additional patient-months of R-CHOP treatment was 69.
• Individual biosimilar conversion analyses showed PPPM savings ranging from $4,429 to $5,036, with NNCs from 55 to 77.

Conclusions:

• Conversion to biosimilar rituximab-based R-CHOP in Medicare for DLBCL offers substantial cost savings compared to originator rituximab.
• These savings can be reinvested to expand access to DLBCL treatment or cover other Medicare costs.
• This study is the first to demonstrate the cost-efficiency and expanded access potential of biosimilar rituximab in DLBCL within the Medicare population.