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Understanding utilization patterns of biologics and biosimilars in the United States to support postmarketing studies of safety and effectiveness
Author(s) -
Dutcher Sarah K.,
FazioEynullayeva Elnara,
Eworuke Efe,
Carruth Amanda,
Dee Elizabeth C.,
Blum Michael D.,
Nguyen Michael D.,
Toh Sengwee,
Panozzo Catherine A.,
Lyons Jennifer G.
Publication year - 2020
Publication title -
pharmacoepidemiology and drug safety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.023
H-Index - 96
eISSN - 1099-1557
pISSN - 1053-8569
DOI - 10.1002/pds.4908
Subject(s) - filgrastim , biosimilar , infliximab , medicine , pharmacology , granulocyte colony stimulating factor , chemotherapy , disease
Purpose To describe utilization of filgrastim and infliximab, the first two products with biosimilars approved in the United States. Methods We identified use of filgrastim (reference, tbo‐filgrastim, and filgrastim‐sndz) and infliximab (reference, infliximab‐dyyb, and infliximab‐abda) in the Sentinel Distributed Database using Healthcare Common Procedure Coding System (HCPCS) codes and National Drug Codes (NDCs) from January 2015 to August 2018. We calculated the proportion of use by code type and assessed uptake over time. We compared baseline patient characteristics and treatment indications. Among patients with >1 exposure episode, we characterized gaps between episodes. Results Use was identified primarily via HCPCS codes (filgrastim: 86.4%‐97.7%; infliximab: 87.8%‐100%) although some was identified via NDCs (filgrastim: 2.2%‐13.5%; infliximab: <0.1%‐6.5%). Filgrastim reference product use declined from 89.4% in January 2015 to 30.3% in June 2018, with corresponding increases in filgrastim‐sndz (0% to 49.3%) and tbo‐filgrastim (10.6% to 20.4%). Infliximab biosimilar uptake was low (9.7% in June 2018). We identified 94 846 filgrastim reference product, 27 143 tbo‐filgrastim, and 38 264 filgrastim‐sndz users. For infliximab, we identified 125 412 reference product, 1034 infliximab‐dyyb, 49 infliximab‐abda, and 4855 undetermined biosimilar users. Patients receiving filgrastim products were largely similar, but differences in age, sex, and indication were observed across infliximab product users. The median exposure episode gap ranged from 1 to 3 days for filgrastim and 48 to 50 days for infliximab. Conclusion Use of biosimilar filgrastim has increased in the United States, but infliximab biosimilar use remains low. Data on identification of biosimilars in claims data and observed gaps between exposure episodes can be used to support drug safety studies of biosimilars.