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  • Intraocular Bevacizumab Biosimilar May Not Be Cost-Effective

    By Stephanie Leveene, ELS
    Selected by Russell N. Van Gelder, MD, PhD
    Retina/Vitreous
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    Journal Highlights

    Ophthalmology, September 2023

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    Anti-VEGF medications cost Medicare Part B more than $3.5 billion annually, but it is unclear whether “on-label” biosimilars can help reduce these costs. An intraocular bevacizumab biosimilar is currently awaiting FDA approval. Zhang et al. created a drug-pricing model using the Medicare average sales price (ASP) for bevacizumab, ranibizumab, and aflibercept, wholesale acquisition costs (WAC) of currently available ranibizumab biosimilars, and theoretical prices for bevacizumab and aflibercept biosimilars. Results from application of this model point to increased costs from a bevacizumab biosimilar and cost reductions from ranibizumab and aflibercept biosimilars.

    As of October 2022, Medicare Part B ASPs for ranibizumab 0.3 mg, ranibizumab 0.5 mg, and aflibercept 2 mg were $776, $1,292, and $1,806, respectively. The respective WACs for biosimilar versions of the two ranibizumab dosages were $816 and $1,130-$1,360; no aflibercept biosimilar is currently available. For purposes of the model, the cost of a bevacizumab biosimilar was estimated to be either $500 or $900.

    The model predicted that an intraocular bevacizumab biosimilar priced at $500 would raise Medicare Part B costs by $457 million per year, and one priced at $900 would raise costs by $897 million per year. Patients wou see increases of $117 million and $229 million, respectively. Switching from ranibizumab and aflibercept to their respective biosimilars could potentially lead to total cost savings of $132 million for Medicare and $33.6 million for patients.

    These findings suggest that the use of off-label or “repackaged” bevacizumab, which has been shown to be safe and effective for retinal diseases, is also cost-effective. The authors summarized their results by calling for an exemption for the intraocular use of repackaged bevacizumab in order to prevent undue burden on prescribers, payers, and patients and to ensure access to critical treatments. “We hope this data can inform future policy and advocacy efforts to preserve access to low-cost repackaged bevacizumab,” they concluded.

    The original article can be found here.