Uptake of oncology-related biosimilars: a global analysis of usage data

Abstract Background Biologics have greatly improved cancer management but are costly. Biosimilars cost less and have no clinically meaningful differences compared to reference products. However, they are not identical, leading to hesitation among clinicians and patients to use them. Objective To measure the uptake of oncology-related biosimilars versus reference products in the USA and countries with similar regulatory frameworks. Methods We conducted a cross-sectional sales analysis from 13 countries between October 2022 and September 2023 for five oncology-related biologics with biosimilars: bevacizumab, filgrastim, pegfilgrastim, rituximab, and trastuzumab. We used IQVIA MIDAS® data on country-level quarterly sales volume and value. Results Among the 13 countries, the USA ranked tenth in the proportion of oncology-related biosimilar uptake by units sold (75% versus median 86%) and spending (58% versus 76%). Biosimilar uptake in the USA was 84% for filgrastim (versus 95%), 83% for bevacizumab (versus 86%), 75% for rituximab (versus 93%), 70% for trastuzumab (versus 70%), and 44% for pegfilgrastim (versus 83%). The USA spent USD $8.4 billion on these biologics during the study period. European countries including Norway, Italy, and Sweden had the highest uptake, while New Zealand, Japan, and Belgium had the lowest. Across countries, biosimilar filgrastim had the highest uptake (95% of units) and trastuzumab the lowest (70%). Conclusions Oncology-related biosimilar uptake in the USA was below-average among included countries. Increasing biosimilar uptake may reduce spending, and savings can be reinvested into cancer care. Future research on time trends can help assess barriers and enablers of biosimilar uptake across countries.