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Background <p>The increasing use of high-cost oncology therapies poses significant challenges for healthcare systems, particularly in low- and middle-income countries. The introduction of biosimilars offers a potential strategy to optimize pharmaceutical expenditure while maintaining clinical outcomes. However, real-world economic evidence from Latin American public healthcare settings remains limited.</p> Objective <p>To evaluate the economic impact of bevacizumab biosimilar adoption in a tertiary public hospital in Ecuador through a cost-minimization analysis and a budget impact analysis based on real-world institutional data.</p> Methods <p>A retrospective observational economic evaluation was conducted using institutional pharmacy data available from January 2019 to June 2, 2026. The database was extracted on June 2, 2026; therefore, data for 2026 represent year-to-date observations. A cost-minimization analysis (CMA) was performed under the assumption of clinical equivalence between originator bevacizumab and its biosimilar (MB02), focusing on direct drug acquisition costs. A budget impact assessment was conducted using an originator-only counterfactual scenario, comparing observed biosimilar expenditure with the hypothetical expenditure that would have occurred if the same number and presentation mix of biosimilar vials had been acquired at originator prices. Cost estimates included real expenditure, hypothetical originator costs, and mean acquisition cost per vial. Uncertainty was explored using bootstrap resampling techniques.</p> Results <p>A total of 6,431 bevacizumab vials were dispensed during the study period, 91.9% of which corresponded to the biosimilar. Biosimilar acquisition costs were substantially lower than those of the originator product across both vial presentations. Under the originator-only counterfactual scenario, hypothetical expenditure was estimated at USD 5,462,097.60 compared with observed biosimilar expenditure of USD 1,963,376.00, resulting in estimated cost avoidance of USD 3,498,721.60 (64.1%). These findings demonstrate substantial cost avoidance and pharmaceutical expenditure containment associated with biosimilar adoption.</p> Conclusion <p>The incorporation of a bevacizumab biosimilar in a tertiary public hospital in Ecuador was associated with substantial cost avoidance under an originator-only counterfactual scenario. These findings support the role of biosimilars as a strategy to improve efficiency and contribute to expenditure containment in in oncology pharmaceutical spending within resource-constrained healthcare settings.</p>

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Real-world cost avoidance associated with bevacizumab biosimilar adoption in a tertiary public hospital in Ecuador: a cost-minimization and budget impact analysis

  • 期刊论文

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  • 发表日期：

    2026年7月10日

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  • Sara Rodríguez,
  • Carla Arias,
  • María del Carmen Aynaguano,
  • Carol Moreno,
  • David Armas

摘要

Background

The increasing use of high-cost oncology therapies poses significant challenges for healthcare systems, particularly in low- and middle-income countries. The introduction of biosimilars offers a potential strategy to optimize pharmaceutical expenditure while maintaining clinical outcomes. However, real-world economic evidence from Latin American public healthcare settings remains limited.

Objective

To evaluate the economic impact of bevacizumab biosimilar adoption in a tertiary public hospital in Ecuador through a cost-minimization analysis and a budget impact analysis based on real-world institutional data.

Methods

A retrospective observational economic evaluation was conducted using institutional pharmacy data available from January 2019 to June 2, 2026. The database was extracted on June 2, 2026; therefore, data for 2026 represent year-to-date observations. A cost-minimization analysis (CMA) was performed under the assumption of clinical equivalence between originator bevacizumab and its biosimilar (MB02), focusing on direct drug acquisition costs. A budget impact assessment was conducted using an originator-only counterfactual scenario, comparing observed biosimilar expenditure with the hypothetical expenditure that would have occurred if the same number and presentation mix of biosimilar vials had been acquired at originator prices. Cost estimates included real expenditure, hypothetical originator costs, and mean acquisition cost per vial. Uncertainty was explored using bootstrap resampling techniques.

Results

A total of 6,431 bevacizumab vials were dispensed during the study period, 91.9% of which corresponded to the biosimilar. Biosimilar acquisition costs were substantially lower than those of the originator product across both vial presentations. Under the originator-only counterfactual scenario, hypothetical expenditure was estimated at USD 5,462,097.60 compared with observed biosimilar expenditure of USD 1,963,376.00, resulting in estimated cost avoidance of USD 3,498,721.60 (64.1%). These findings demonstrate substantial cost avoidance and pharmaceutical expenditure containment associated with biosimilar adoption.

Conclusion

The incorporation of a bevacizumab biosimilar in a tertiary public hospital in Ecuador was associated with substantial cost avoidance under an originator-only counterfactual scenario. These findings support the role of biosimilars as a strategy to improve efficiency and contribute to expenditure containment in in oncology pharmaceutical spending within resource-constrained healthcare settings.