European Journal of Biomedical and Pharmaceutical Sciences

PHARMACOECONOMIC IMPACT OF BIOSIMILARS AND ORIGINATOR DRUGS IN COLORECTAL CANCER TREATMENT IN DEVELOPING COUNTRIES

Kenan Selmanovic MD MSc*, Lamija Zecevic-Pasic MD PhD, Ermin Begovic MD, Svjetlana Loga-Zec MD PhD

ABSTRACT

ABSTRACT

Background: Colorectal cancer (CRC) represents a significant public health and economic burden, especially in countries with limited resources. Biological therapies significantly improve treatment outcomes, but their highcost limits availability. The introduction of biosimilars enables the rationalization of costs and the wider application of efficient therapy, making pharmacoeconomic analysis a key tool for optimizing health policies. Aim: This study aims to assess the pharmacoeconomic implications of substituting originator biologics with biosimilar drugs in the treatment of colorectal cancer in Bosnia and Herzegovina, a developing country. Patients and Methods: The study is designed as a retrospective-prospective, comparative analysis of biosimilars and originator drugs used in Colorectal Cancer Treatment in Bosnia and Herzegovina over a five-year period (from january 2020. to december 2024.). Data were collected from the IMS (Intercontinental Marketing Service) database. The study analyzed the total consumption of the active substance bevacizumab, the total costs and the average price expressed in euros, number of patients with colorectal carcinoma covered by the therapy. Results: The data reveal a significant increase in both the number of patients treated for CRC and the total consumption of bevacizumab from 2020 to 2024. Initially, from January 2020 to July 2022, only the originator biologic, Avastin, was used, with 691 patients treated and a total active substance consumption of approximately 6.28 million mg. The total expenditure during this period was over €13.8 million, with an average monthly cost per patient around €608.17. Post-2022, the introduction of biosimilars alongside the originator drug coincided with increased treatment coverage, reaching 1,169 patients and a total active substance use of approximately 10.64 million mg. Notably, the total expenditure remained relatively stable (~€13.4 million), but the average cost per treatment decreased significantly from €608.17 to €329.64, reflecting the economic impact of biosimilar adoption. Conclusion: The increasing adoption of biosimilars in Bosnia and Herzegovina has led to significant cost savings and improved access to biologic therapies for CRC, without compromising treatment quality.

Keywords: Pharmacoeconomic analysis, Colorectal carcinoma treatment, biosimilars, originator drugs.