Rituximab Biosimilars Produce Big Cost Savings, are Effective

A large Netherlands study demonstrated that rituximab biosimilars (R-biosimilars) produced a 43%reduction in annual costs. In addition, three-year overall survival did not differ between diffuse large B-cell lymphoma (DLBCL) and those receiving rituximab, according to the researchers.

Researchers at the Netherlands Comprehensive Cancer Organisation (IKNL) in Utrecht, The Netherlands, and other facilities, wrote in the journal Blood Advances that the Dutch Association of Medical Specialists stated to adopt Biosimilars into standard of care in 2017.

As a result, due to the “considerably lower purchase costs of R-biosimilars compared with R-originator (up to 50%), the Netherlands was one of the first countries to implement R-biosimilars in its health care system,” the researchers wrote.

In fact, by the end of 2018, 91% of rituximab (manufactured by Genentech and marketed in the US as Rituxan by Biogen) purchased in the Netherlands were biosimilars.

“R-biosimilars may have major health economic consequences. With a worldwide R-originator sales increase of 1% in 2017, purchase percentages of R-originator decreased by 8% and 4% in 2018 and 2019, respectively,” the researchers wrote.

The highest conversion rate occurred in Europe with a 33% purchase reduction of the R-originator in 2019. “Despite approval in 2018, the first R-biosimilar was only marketed in November 2019 in the United States, In that same year, the relative expenditure on R-originator in the Netherlands was 43% lower than in 2015,” they noted.

Despite the known cost savings, the authors wanted to test the real-world overall survival rates of patients with newly diagnosed DLBCL taking R-biosimilars to see if they were equivalent to that of rituximab.

They evaluated more than 4,400 patients in a nationwide, population-based cancer registry in the Netherlands. The patients, diagnosed between 2014 and 2018, received at least 1 cycle of rituximab combined with cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP).

“Collectively, our data show that patients with DLBCL benefit equally from R-originator or R-biosimilars combined with CHOP treatment,” the researchers wrote.

Other studies have also supported the use of Rituxan biosimilars to treat DLBCL. In a 2020 study, published in Leukemia & Lymphoma, researchers found that the rituximab biosimilar CT-P10 (Truxima, Celltrion) successfully replaced rituximab in diffuse large B-cell lymphoma (DLBCL) treatment.

“These data support the ability of CT-P10 to successfully replace originator rituximab in DLBCL treatment and, given the lowered financial barrier, to improve the overall prognosis for DLBCL patients,” the researchers wrote.