Financial Incentives Increase Utilization of Biosimilars for Oncology Care

Financial incentives to hospitals could increase the utilization of biosimilars, specifically in the adoption of oncology biosimilars, according to study findings published in PLOS ONE.¹

Biosimilars, Oncology, Financial Incentives | Image Credit: © lexiconimages | stock.adobe.com

In a survey from 2020 with results published in The Lancet Oncology, of all oncology drugs approved in 2019 in the European Union (EU), US, and Japan, 27% of new cancer drug approvals were biologics. Between 2007 and 2020, 16 biosimilars for oncology were approved by the FDA, 33 by the European Medicines Agency, and 10 in Japan. In that study, pharmacists in the EU could substitute biosimilars for the reference product, but that was not established in the US or Japan. In the current study, the study authors acknowledge that biologics are expensive and result in a burden of health care costs; biosimilars could help reduce this cost.^1,2

Investigators aimed to identify an association between financial incentives and biosimilar uptake in favor of the reference product for oncology products. They gathered data from acute care hospitals that willingly chose to participate in the study, including more than 500 hospitals across Japan, from August 21 to November 20, 2023. The new health plan with the incentive was introduced on April 1, 2022, under which the study authors stated “Eligible hospitals may receive an additional fee of 1,500 JPY (≈ 10.4 US dollars: USD, 9.5 Euro: EUR) per patient per month for up to 3 months” when using a biosimilar formulation of rituximab, trastuzumab, and bevacizumab to initiate chemotherapy or when switching the reference product to the biosimilar. Of note, patients had to be informed of the biosimilar product’s efficacy and safety before starting the therapy.¹

Patients included had a primary disease of gastric cancer, colorectal cancer, lung cancer, breast cancer, B-cell lymphoma, or B-cell proliferative disease and received chemotherapy with one of the drugs included in the study. Further, patients that had data for all 39 months were included. The primary outcome included the proportion of monthly prescriptions for biosimilar products compared with prescriptions for the reference product, and the secondary outcome included monthly costs of biosimilars and the reference products.¹

Investigators included 27,737 patients from 114 hospitals, where 63 hospitals were eligible for financial incentives. For hospitals that were eligible and ineligible, the average proportion of overall prescriptions increased for biosimilar products, and reference products decreased for both hospital types. The results showed that financial incentives were related to an increase in the proportion of biosimilar prescriptions at 0.092 per month (95% CI, 0.040–0.145) [9.2%, 95% CI, 4.0–14.5] compared to ineligible hospitals.The average monthly expenditures for both the biosimilar products and reference products for both hospital types decreased gradually, according to the investigators. However, the monthly expenditure was not significantly associated with the incentives, with the impact being 1872.958 (1,000 JPY) (95% CI: -120.918 to 3866.835).¹

The investigators concluded that the recent health policy introduced in Japan could potentially be effective in increasing use of biosimilars with these financial incentives.¹

REFERENCES

1. Itoshima H, Takada D, Goto E, Sasaki N, Kunisawa S, Imanaka Y. The impact of financial incentives promoting biosimilar products in oncology: A quasi-experimental study using administrative data. PLoS One. 2024;19(11):e0312577. Published 2024 Nov 14. doi:10.1371/journal.pone.0312577

2. Bennett CL, Schoen MW, Hoque S, et al. Improving oncology biosimilar launches in the EU, the USA, and Japan: an updated Policy Review from the Southern Network on Adverse Reactions [published correction appears in Lancet Oncol. 2021 Feb;22(2):e42. doi: 10.1016/S1470-2045(21)00023-1]. Lancet Oncol. 2020;21(12):e575-e588. doi:10.1016/S1470-2045(20)30485-X