PCN198 - Utilization Patterns Of The First US Biosimilar, Filgrastim-Sndz, Observed Between 2015 And 2017 In A Medical Transcription Database

Abstract

Filgrastim-sndz (FIL-SNDZ), the first US biosimilar, is replacing filgrastim (FIL) on a growing number of drug formularies since market entry in September 2015. The American Society of Clinical Oncology clinical practice guidelines recommend FIL-SNDZ as a granulocyte colony-stimulating factor (G-CSF) for preventing treatment-related febrile neutropenia in patients with nonmyeloid malignancies receiving myelosuppressive chemotherapy. This study aimed to identify FIL-SNDZ utilization during patients’ healthcare encounters and to compare annual utilization versus other G-CSFs between 2015 and 2017. Physician records were extracted (1/1/2015–11/30/2017) from RealHealthData, a US nationwide medical transcription database providing data within 30 days of each patient visit to a participating provider. Records were queried for mention of FIL-SNDZ, tbo-filgrastim (TBO-FIL), FIL, or pegfilgrastim (PEG), with the annual percentage share of G-CSFs received by unique patients compared across years. Data will be refreshed in March 2018. Among 20,427 unique patients with 36,885 records mentioning a G-CSF between 2015 and 2017, G-CSF utilization patterns changed. In 2015, 65.7% of patients had a mention of PEG, 33.2% of FIL, and 1.2% of TBO-FIL; none mentioned FIL-SNDZ. In 2016, G-CSF mentions were 51.6% (PEG), 37.4% (FIL), 10% (TBO-FIL) and 1% (FIL-SNDZ). Values changed marginally in 2017 to 49.5% (PEG), 41.4% (FIL), 8% (TBO-FIL) and 1% (FIL-SNDZ). Notwithstanding broad geographic distribution of contributing providers, these trends may not represent G-CSF utilization across the United States and may vary when data through 12/31/2017 are added. Despite over 2 years on the US market and increasing emergence on commercial formularies since January 2017, this investigation of medical transcription records observed limited (~1%) utilization of the biosimilar FIL-SNDZ. The larger market share of long-acting PEG versus short-acting FIL may be a factor in the low uptake of FIL-SNDZ. Further research is warranted to understand why uptake of biosimilar G-CSF remains low in the United States.