Biosimilar Use on the Rise in Oncology Practices

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Researchers looked at the use of 6 biosimilars across 38 oncology practices and found that biosimilar use increased from 2019 to 2021.

The use of biosimilars is increasing in US oncology practices, according to a study published in JCO Oncology Practice.

Researchers looked at the use of 6 biosimilars across 38 oncology practices and found that biosimilar use increased from 2019 to 2021. Over the same time period, the cost of biosimilars and their originator products decreased.

This study included oncology practices participating in PracticeNet. Researchers evaluated the use of biosimilars for bevacizumab, epoetin alfa, filgrastim, pegfilgrastim, rituximab, and trastuzumab from 2019 to 2021. 

The mean use of all 6 biosimilars increased from the first quarter of 2019 to the fourth quarter of 2021:

  • Bevacizumab  — 0% to 79.4%;
  • Epoetin alfa — 8.0% to 70.6%;
  • Filgrastim — 67.4% to 80.0%;
  • Pegfilgrastim — 14.3% to 51.2%;
  • Rituximab — 0% to 69.9%;
  • Trastuzumab — 0% to 75.4%.

The researchers also looked at costs over time using Medicare payment limits (MPLs). The average MPL per dose of all originator and biosimilar products decreased from January 2019 to December 2021:

  • Bevacizumab — $4568.86 to $2918.26;
  • Epoetin alfa — $424.12 to $323.93;
  • Filgrastim — $308.23 to $183.08; 
  • Pegfilgrastim — $4684.08 to $2952.07; 
  • Rituximab — $5572.37 to $3809.66; 
  • Trastuzumab — $4702.67 to $2851.45.

“These decreases in price were driven by the introduction of lower-cost biosimilars, as well as decreasing trends in prices of originator and available biosimilars,” the researchers noted. “In most cases, a biosimilar remained the least costly alternative throughout the 3 years; exceptions include epoetin alfa and pegfilgrastim, where the originator biologic competed more aggressively on price.”

The researchers also conducted a survey of physicians and administrators at 17 practices to identify potential motivators and barriers to biosimilar use.

Most respondents said they are familiar with biosimilar availability (94%) and safety (88%). Fewer said they are familiar with requirements for biosimilar approval (59%) and safety monitoring processes used by the US Food and Drug Administration (35%). 

Most respondents said their organizations support the use of biosimilars through pharmacy-driven substitution of ordered biologics in new treatment plans (82%), purchasing agreements favoring biosimilar use (41%), and payer agreements incentivizing biosimilar use (29%). None of the organizations reported discouraging the use of biosimilars.

“In the effort to accelerate safe and widespread adoption of biosimilars, we recommend continuing research efforts to use real-world, postmarket evidence to demonstrate the safety, effectiveness, and value of each unique biosimilar product,” the researchers wrote. 

Disclosures: This research was supported by Pfizer. Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.


Bourbeau B, Lyman GH, Lei XJ, et al. Biosimilar use among 38 ASCO PracticeNET practices, 2019-2021. JCO Oncol Pract. Published online April 21, 2023. doi:10.1200/OP.22.00618

This article originally appeared on Cancer Therapy Advisor