がん治療薬の低価格代替品、治療費削減につながる可能性(Lower-cost alternatives to cancer drugs may cut treatment costs)

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2026-09-23 カリフォルニア大学ロサンゼルス校(UCLA)

UCLAの研究チームは、がん治療に用いられる生物学的製剤について、先行品と「バイオシミラー(バイオ後続品)」の費用を比較した。2020~2023年にベバシズマブ、リツキシマブ、トラスツズマブの治療を開始した14,655件の患者・薬剤ペアを保険請求データから追跡した結果、バイオシミラーのみを使用した患者では、先行品のみを使用した患者に比べ、調整後の保険者負担が月平均3,820ドル、患者の自己負担が39.50ドル低かった。また、バイオシミラー参入後、先行品の平均販売価格と市場シェアも低下していた。研究は、バイオシミラーの普及ががん治療の経済的負担軽減につながる可能性を、実臨床データから検討したもの。なお、研究は後ろ向きコホート分析であり、費用差をすべてバイオシミラー使用の因果効果と断定するものではない。

<関連情報>

バイオシミラー導入後の癌治療用生物製剤の利用状況と、支払者および患者への経済的影響 Cancer Biologics Utilization After Biosimilar Entry and Financial Implications For Payers and Patients

Xiaoyu Liu, PhD; Xiaoyi Xu, MS; Z John Lu, PhD:et al
JAMA Oncology  Published:August 27, 2026
DOI:10.1001/jamaoncol.2026.3128

Key Points

Question What is the utilization pattern of anticancer biologics after biosimilars became available and the subsequent financial implications for patients and payers?

Findings In this cohort study of 14 655 patient-drug pairs, compared with patients who only used the originator biologics, those who only used biosimilars rendered $3820 lower mean monthly payer costs and $39.50 lower mean monthly out-of-pocket costs.

Meaning The study results suggest that exclusively using biosimilars has lowered financial burden for payers and patients.

Abstract

Importance Biosimilars are highly similar to originator biologics and were introduced to increase market competition, lower the price of biologics, and expand patient access by improving affordability. By the end of 2024, three anticancer biologics have experienced biosimilar entry in the US (bevacizumab, rituximab, and trastuzumab), underscoring the need to evaluate their financial implications for payers and patients.

Objective To assess market dynamics and examine financial implications associated with biosimilar use patterns among patients who received bevacizumab, rituximab, or trastuzumab.

Design, Setting, and Participants This retrospective cohort examined price and market share trends and payer and patient costs after biosimilar entry. It used data from the Merative MarketScan commercial database and Medicare database from July 2019 to December 2024. Based on use patterns within 12 months of treatment initiation, patients were categorized into 4 groups: those who exclusively used biosimilars, exclusively used the reference product (ie, originator biologics), switched from the reference product to biosimilars, and switched from biosimilars to the reference product. Data were analyzed between September 2025 and March 2026.

Main Outcomes and Measures The primary study outcomes were average sales price (ASP), market share of reference products, and mean monthly payer and out-of-pocket costs within the study period.

Results Among 14 655 patients in this study, the mean (SD) age was 57 (13) years, 9985 (68.1%) were female, and the most common cancers were breast cancer (5182 [35.4%]), lymphoma (4320 [29.5%]), and colorectal cancer (1998 [13.6%]). A total of 8710 patients (59.4%) exclusively used biosimilars, 4760 (32.5%) exclusively used the reference product, 1015 (6.9%) switched from the reference product to biosimilars, and 170 (1.2%) switched from biosimilars to the reference product. After biosimilar entry, the ASP of the 3 reference products declined by an average of 3.8% annually. Their market share decreased 30% annually in commercial insurance and 31.5% in the Medicare Part B market. Compared with patients who only used the reference product, those who only used biosimilars rendered a $3820 lower mean monthly payer cost and $39.50 lower mean monthly out-of-pocket cost.

Conclusions and Relevance The results of this cohort study suggest that biosimilar entry was associated with lower ASP and reduced market share for reference biologics in oncology. Market competition introduced by biosimilars was also associated with lowered payer costs and reduced patient financial burden.

医療・健康
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