Cost-efficiency analysis and expanded treatment access modeling of conversion to rituximab biosimilars from reference rituximab in Jordan

Abstract

Aim

To assess the cost-efficiency and expanded access of three rituximab biosimilars versus the reference rituximab from the perspective of the Jordanian national health payer.

Methods

A 1-year cost-efficiency and expanded access model of conversion from reference rituximab (Mabthera) to the approved biosimilars (Truxima, Rixathon, and Tromax) to assess five metrics: total annual cost to treat a hypothetical patient; head-to-head cost comparison; changes in patients’ access to rituximab; number-needed-to-convert (NNC) to provide an additional 10 patients access to a rituximab treatment; and relative amount of Jordanian Dinar (JOD) spent on rituximab options. The model included rituximab doses at 100 mg/10 ml and 500 mg/50 ml and considered both cost-saving and cost-wastage scenarios. Costs of treatments were based on the fiscal year 2022 tender prices received by the Joint Procurement Department (JPD).

Results

Rixathon was associated with the lowest average annual cost per patient (JOD2,860) across all six indications among all rituximab comparators, followed by Truxima (JOD4,240), Tromax (JOD4,365) and reference Mabthera (JOD11,431). The highest percentage of patient access to rituximab treatment (321%) was achieved when switching patients from Mabthera to Rixathon in the RA and PV indications. At four patients, Rixathon was associated with the lowest NNC to provide an additional 10 patients access to rituximab treatment. For each JOD1 spent on Rixathon, an additional JOD3.21 must be spent on Mabthera, an additional JOD0.55 on Tromax, and an additional JOD0.53 on Truxima.

Conclusion

Rituximab biosimilars were associated with cost savings in all approved indications in Jordan compared to reference rituximab. Rixathon was associated with the lowest annual cost, the highest percentage of expanded patient access for all six indications, and the lowest NNC providing 10 additional patients with access.

Keywords:

• Biosimilars
• cost-efficiency
• expanded access
• Jordan
• rituximab

JEL CLASSIFICATION CODES:

• H51
• H5
• H
• I15
• I1
• I

Transparency

Declaration of funding

The work reported herein was performed without sponsorship or grant funding.

Declaration of financial/other relationships

The authors report there are no competing interests to declare.

Author contributions

All authors met ICMJE and COPE criteria and contributed substantively to the study as follows: study concept, IA, LM, NA, HH; study design, HH, NA, IA; model development and simulations, HH; review and interpretation of results, HH, NA, IA, AA, MS, SH, OR, LM; Development of manuscript: HH, NA, IA, SH, OR; critical revisions to the manuscript: all authors.

Acknowledgements

None reported.

Data availability statement

The raw data that support the findings of this study are available from the corresponding author, upon reasonable request.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Disclaimer

The contents of this manuscript are solely the authors’ views and may not be understood or quoted as being made on behalf of reflecting the position of the Saudi Food and Drug Authority.

Notes

i Mabthera is a registered trademark of Roche Diagnostics GmbH, Mannheim, Germany.

ii Truxima is a registered trademark of Hikma, Amman, Jordan.

iii Rixathon is a registered trademark of Novartis, Basel, Switzerland.

iv Tromax is a registered trademark of MS Pharma, Amman, Jordan.