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Cancer Biologics Utilization After Biosimilar Entry and Financial Implications For Payers and Patients

JAMA Oncology·August 27Open Access
OncologyPractice changingBreast CancerColorectal CancerLymphomaRetrospective Cohort StudyBiosimilarMonoclonal AntibodyAdultAvastinHerceptinRituxanBevacizumabRituximabTrastuzumab

Summary

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What was studied

This retrospective cohort study examined market dynamics and financial implications of biosimilar entry for bevacizumab, rituximab, and trastuzumab among 14,655 patients in commercial and Medicare Part B insurance, using claims data from July 2019 to December 2024.

Key findings

Biosimilar-only use (59.4% of patients) was associated with $3,820 lower mean monthly payer costs and $39.50 lower mean monthly out-of-pocket costs vs. reference product-only use; reference product average sales price fell 3.8% annually and market share dropped ~30–31.5% per year after biosimilar entry.

Study limitations

Retrospective claims-based design limits causal inference; data restricted to commercially insured and Medicare Part B patients, excluding Medicaid and uninsured; biosimilar entry timing differed across the three agents, complicating pooled trend analysis.

Clinical implications

Biosimilars for bevacizumab, rituximab, and trastuzumab meaningfully reduce costs for both payers and patients without evidence of compromised access. Clinicians and health systems should favor biosimilar initiation as the default to maximize affordability benefits.

Related Questions

Explore related topics

How does biosimilar adoption for trastuzumab affect patient out-of-pocket costs in Medicare?What barriers prevent oncology patients from switching from reference biologics to biosimilars?How do biosimilar market share trends in oncology compare between commercial insurance and Medicare Part B?

Publication Details

Year
2026
Journal
JAMA Oncology
Sample Size
n=14,655
Source
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