Substituting for Costlier Drugs Reduced Total Cost of Care

By Leah Lawrence - Last Updated: October 18, 2022

The substitution of costlier drugs for biosimilars, generics, or other clinically appropriate lower-cost drugs could be an effective way to reduce cost of care by approximately 5%, while also maintaining quality of care for patients with cancer, according to a recent study.

Erica Feinberg, PharmD, BCPS, senior clinical data analyst, The US Oncology Network, The Woodlands, Texas, presented results of the study looking at therapeutic interchange (TIC) at the 2022 American Society of Clinical Oncology (ASCO) Quality Care Symposium.

Developed by the Center for Medicare & Medicaid Innovation, the Oncology Care Model (OCM) is a value-based care program that rewards practices for decreasing total cost of care compared with a benchmark price. In this study, the researchers looked at Medicare parts B and D claims for 14 OCM practices in The US Oncology Network and evaluated the impact of 8 TIC opportunities during Performance Periods 7, 8, and 9.

The cumulative savings were $26.0 million, $32.3 million, and $32.9 million per consecutive 6-month interval between July 2019 and December 2020. Switching to biosimilars contributed $6.6 million in savings in the first 6 months of 2020 and $12.2 million in the last 6 months of 2020. Overall, the switches reduced the total cost of oncology drug care by 2.78%, 4.13%, and 5.25% in 6-month intervals of the OCM between July 2019 and December 2020, consecutively.

The researchers noted that there is room for this benefit to continue as long as price differences exist between 2 interchangeable products.

Commenting on the study, ASCO Chief Medical Officer and Executive Vice President Julie R. Gralow, MD, FACP, FASCO, said, “This study shows that with the use of lower-cost alternatives, patients can benefit from lower copays and lower out-of-pocket expenses without forgoing quality care. This is a proverbial win-win situation where the patient benefits not only from the same quality of care but is able to access it at a lower price.”

Source: Therapeutic Interchange: The Cornerstone of Cost Effectiveness in the Oncology Care Model Performance for The U.S. Oncology Network