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Budget Impact of Switching to Biosimilar Trastuzumab (CT-P6) for the Treatment of Breast Cancer and Gastric Cancer in 28 European Countries

  • Seung-Mi Lee
  • Jae-Ho Jung
  • David Suh
  • Yu-Seon Jung
  • Seung-Lai Yoo
  • Dong-Won Kim
  • Ji-An Kim
  • Dong-Churl SuhEmail author
Original Research Article



As the economic burden of treating cancer patients has been soaring in European countries, performing a budget impact analysis is becoming one of the requirements for payers’ application dossiers.


The objective of this study was to estimate the budgetary impact of introducing the biosimilar trastuzumab (CT-P6) from the payer’s perspective and to determine the number of additional patients who could be treated with resulting savings in 28 European countries.


A budget impact model was developed to analyze the financial impact of switching from originator trastuzumab to biosimilar CT-P6 in the treatment of early and metastatic breast cancer and metastatic gastric cancer with a time horizon of 1–5 years. Budgetary savings and the number of patients potentially affected were measured based on epidemiological and sales volume data. The base-case analysis assumed that the price of CT-P6 is 70% of the originator price, the switching rate of originator to CT-P6 in the first year is 20%, and the annual growth in the switching rate for each subsequent year is 5%.


For analyses using the base-case scenario following CT-P6 introduction, the total estimated budgetary savings over a 5-year period (depending on the scenario) ranged from €1.13 billion to €2.27 billion based on epidemiological data, or from €0.91 billion to €1.82 billion based on sales volume data. In the first year only, the projected budgetary savings ranged from €58 million to €136 million, and the number of additional patients who could be treated using the savings ranged from 3503 to 7078 by sensitivity analysis.


The conducted budget impact analysis assessing a switch from originator trastuzumab to biosimilar CT-P6 in 28 European countries indicates that budget savings could be between €0.91 billion and €2.27 billion over the next 5 years. These savings could be used to help improve patient access to local biologics in their respective countries while simultaneously strengthening the overall public health landscape across the European Union.



The authors would like to thank Gil-Hwan Lew for the study design and data collection and analysis in the early stages of this study. Editorial support (which included editing and styling an advanced draft provided by the authors) was provided by Emma Evans PhD at Aspire Scientific (Bollington, UK).

Author Contributions

S.-M. Lee and J.-H. Jung contributed equally to the study design, statistical analysis, and manuscript development under the guidance of D.-C. Suh. D. Suh, Y.-S. Jung, S.-L. Yoo, D.-W. Kim, and J.-A. Kim contributed to the acquisition, analysis, and interpretation of data and were involved in drafting and revising the manuscript. All authors have approved the submitted version to be published and agree to be accountable for aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. The sponsor was not involved in the study design or in the analysis and interpretation of the data.

Compliance with Ethical Standards


This research was supported by the Chung-Ang University research grant in 2019. This study was partially funded by a research grant including editorial support from Celltrion Healthcare Co., Ltd. (Incheon, Republic of Korea).

Conflict of Interest

S.-M. Lee, J.-H. Jung, D. Suh, Y.-S. Jung, S.-L. Yoo, D.-W. Kim, J.-A. Kim, and D.-C. Suh declare that they have no conflict of interest.


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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.College of PharmacyChung-Ang UniversitySeoulSouth Korea
  2. 2.Mailman School of Public HealthColumbia UniversityNew YorkUSA

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