Jennifer Fenna1, Micheal Guirguis2, Caroline Ibrahim3, Neeta Shirvaikar4, Irwindeep Sandhu5, Sunita Ghosh6, Melissa Jenkins7. 1. , BScPharm, MHS, is a Drug Utilization and Stewardship Pharmacist with Pharmacy Services, Alberta Health Services, Edmonton, Alberta. 2. , BScPharm, PhD, is a Drug Stewardship Pharmacist with Pharmacy Services, Alberta Health Services, and is an Academic Adjunct Colleague with the Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, Alberta. 3. , BSc, BPharm, MHS, is a Drug Utilization and Stewardship Pharmacist with Pharmacy Services, Alberta Health Services, Edmonton, Alberta. 4. , BSc, MSc, MS, PhD, is a Quality Management Consultant with the Northern Alberta Blood and Marrow Transplant Program, Cross Cancer Institute, Edmonton, Alberta. 5. , MD, is an Associate Professor with the Division of Clinical Hematology, Department of Medicine, University of Alberta, Edmonton, Alberta. 6. , PhD (Biostatistics), PStat, PStat® (ASA), is a Biostatistician with the Cross Cancer Institute, Alberta Health Services, Edmonton, Alberta. 7. , BSc, is a Clinical Research Coordinator with the Alberta Blood and Marrow Transplant Program, Holy Cross Centre - Tom Baker Cancer Centre, Calgary, Alberta.
Abstract
BACKGROUND: Following addition of a biosimilar filgrastim product to the formulary, sites in the authors' provincial health authority transitioned from using the originator filgrastim to the biosimilar for autologous stem cell mobilization. OBJECTIVE: To assess the effect on patient outcomes of a universal change to use of the biosimilar filgrastim in stem cell mobilization. METHODS: This retrospective pre-post study included patients undergoing autologous stem cell mobilization at 2 cancer hospitals in Alberta, Canada, between July 1, 2018, and November 30, 2019. Clinical outcomes were investigated for patients treated with a granulocyte colony-stimulating factor (biosimilar or originator product) for mobilization before stem cell transplant, approximately 6 months before and after the defined date of product change. RESULTS: In total, 102 patients were treated with the originator product and 101 patients with the biosimilar. Effectiveness was similar between the originator and biosimilar products, with 98% successful harvest of stem cells in all patients treated. Independent t tests showed no statistically significant differences between patients receiving the originator and those receiving the biosimilar in terms of time from mobilization to collection (difference of means -0.9 days, 95% confidence interval [CI] -2.12 to 0.32), time for neutrophil engraftment (difference of means 0 days, 95% CI -0.36 to 0.36), time for platelet engraftment (difference of means 1 day, 95% CI -0.55 to 2.55), average length of stay (difference of means -0.7 day, 95% CI -2.71 to 1.31), and CD34+ value (difference of means -1 × 106/kg body weight, 95% CI -2.11 to 0.11). A 98% rate of conversion to use of the biosimilar filgrastim was achieved, with an estimated annual drug-cost saving of $67 500. CONCLUSIONS: In this pre-post study, changing to the biosimilar product from the originator maintained clinical effectiveness outcomes while decreasing overall drug expenditures. A well-planned change to the biosimilar product, executed in conjunction with clinician consultation and monitoring of effectiveness outcomes, can ensure appropriate patient therapy while significantly improving the uptake of biosimilars and decreasing expenditures for biologic drugs. 2021 Canadian Society of Hospital Pharmacists. All content in the Canadian Journal of Hospital Pharmacy is copyrighted by the Canadian Society of Hospital Pharmacy. In submitting their manuscripts, the authors transfer, assign, and otherwise convey all copyright ownership to CSHP.
BACKGROUND: Following addition of a biosimilar filgrastim product to the formulary, sites in the authors' provincial health authority transitioned from using the originator filgrastim to the biosimilar for autologous stem cell mobilization. OBJECTIVE: To assess the effect on patient outcomes of a universal change to use of the biosimilar filgrastim in stem cell mobilization. METHODS: This retrospective pre-post study included patients undergoing autologous stem cell mobilization at 2 cancer hospitals in Alberta, Canada, between July 1, 2018, and November 30, 2019. Clinical outcomes were investigated for patients treated with a granulocyte colony-stimulating factor (biosimilar or originator product) for mobilization before stem cell transplant, approximately 6 months before and after the defined date of product change. RESULTS: In total, 102 patients were treated with the originator product and 101 patients with the biosimilar. Effectiveness was similar between the originator and biosimilar products, with 98% successful harvest of stem cells in all patients treated. Independent t tests showed no statistically significant differences between patients receiving the originator and those receiving the biosimilar in terms of time from mobilization to collection (difference of means -0.9 days, 95% confidence interval [CI] -2.12 to 0.32), time for neutrophil engraftment (difference of means 0 days, 95% CI -0.36 to 0.36), time for platelet engraftment (difference of means 1 day, 95% CI -0.55 to 2.55), average length of stay (difference of means -0.7 day, 95% CI -2.71 to 1.31), and CD34+ value (difference of means -1 × 106/kg body weight, 95% CI -2.11 to 0.11). A 98% rate of conversion to use of the biosimilar filgrastim was achieved, with an estimated annual drug-cost saving of $67 500. CONCLUSIONS: In this pre-post study, changing to the biosimilar product from the originator maintained clinical effectiveness outcomes while decreasing overall drug expenditures. A well-planned change to the biosimilar product, executed in conjunction with clinician consultation and monitoring of effectiveness outcomes, can ensure appropriate patient therapy while significantly improving the uptake of biosimilars and decreasing expenditures for biologic drugs. 2021 Canadian Society of Hospital Pharmacists. All content in the Canadian Journal of Hospital Pharmacy is copyrighted by the Canadian Society of Hospital Pharmacy. In submitting their manuscripts, the authors transfer, assign, and otherwise convey all copyright ownership to CSHP.
Authors: Anthony S Russell; Vandana Ahluwalla; Cheryl Barnabe; Shahin Jamal; Robert C Offer; Wojciech P Olszynski; Kam Shojania; Boulos Haraoui Journal: Clin Rheumatol Date: 2012-08-26 Impact factor: 2.980
Authors: Pavan Kumar Bhamidipati; Mark A Fiala; Brenda J Grossman; John F DiPersio; Keith Stockerl-Goldstein; Feng Gao; Geoffrey L Uy; Peter Westervelt; Mark A Schroeder; Amanda F Cashen; Camille N Abboud; Ravi Vij Journal: Biol Blood Marrow Transplant Date: 2017-08-07 Impact factor: 5.742