Rituximab biosimilar adoption presentation at ACCP highlights utility of real-world data

In our second collaborative research project from The Craneware Group’s Clinical Solutions team and the LIU Pharmacy Fellowship in Health Analytics and AI, we are thrilled to share findings presented recently at the 2022 American College of Clinical Pharmacy’s Virtual Poster Symposium. In just over one month, our research team developed and executed a project to assess the real-world uptake of rituximab versus biosimilar products for oncology vs. non-oncology indications.

The problem

Biosimilars are as safe and effective as their originator product and show promise as favorable, cost-effective treatment options for both patients and institutions. Currently, rituximab, a drug commonly used to treat non-Hodgkin’s lymphoma as well as other cancer and non-cancer related diseases, has three biosimilars available on the U.S. market: rituximab-abbs (Truxima®), rituximab-pvvr (Ruxience®), and more recently, rituximab-arrx (Riabni™).

Although real-world studies have compared rituximab biosimilar use to the originator product, their focus was predominantly on oncology indications. Limited data exist on the adoption of rituximab biosimilars versus the originator product by oncology versus non-oncology indications.

Is there a difference between the utilization of rituximab biosimilars and their originator product for oncology versus non-oncology indications? Our study aimed to be the first to assess the utilization of all three rituximab biosimilars and capture the largest real-world data study population. Previously, the most extensive study was a 2020 budget impact analysis of 420 patients comparing rituximab to hypothetical biosimilars by Boidart and colleagues.

Our findings

We analyzed more than 28,025 encounters with dispensations of rituximab and its biosimilars between December 2018 and February 2022 across 193 facilities. We captured 23,295 dispensations of the originator rituximab product and 4,630 dispensations of its biosimilars (rituximab-abbs, n=2,550, rituximab-pvvr, n=2,081, rituximab-arrx, n=0).

Product use by indication over the three-year study period showed an increase in biosimilar uptake, with higher adoption for oncology indications. Overall product use spanning the study period revealed decreased originator utilization (99.99% to 40.1%) and increased biosimilar use (0.01% to 59.9%).

We also noted higher oncology and non-oncology use of rituximab and biosimilars in urban and outpatient settings than in rural and inpatient settings (p<0.01 for both comparisons). Non-academic settings had higher overall biosimilar adoption than academic settings (70.3% vs. 48.8%, p<0.01). In addition, a higher proportion of biosimilar use was attributed to on-label indications (67.7%) compared to their originator (58%, p<0.01).

Using 2020 dispensation data and wholesale acquisition costs for these products, a 20% switch from the originator drug, rituximab, to a biosimilar would result in estimated annual net savings of $1,602,675 and $2,218,520 for oncology and non-oncology indications, respectively. These cost savings could significantly benefit hard-hit health-system budgets, with even higher potential savings with increased biosimilar adoption.

This project showcases the utility of The Craneware Group’s innovative and robust pharmacy analytics capabilities by providing meaningful insights into real-world clinical trends of rituximab biosimilar uptake.