ASCO20: Switching to Generic Bortezomib Can Yield Significant Cost Savings


The study’s authors examined the opportunity to decrease the overall cost of bortezomib by $300-400 million by switching patients to the generic version.

Multiple Myeloma

A study published in the 2020 American Society of Clinical Oncology (ASCO) Virtual Scientific Program demonstrated that switching from subcutaneous (SubQ) to generic intravenous (IV) bortezomib can significantly mitigate the overall cost of bortezomib for patients.1,2

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It is estimated that the United States spent $370 billion in 2019 on pharmaceuticals, and by 2020 the cost of cancer will reach $158 billion, the study investigators wrote. Global sales in 2019 from SubQ bortezomib will exceed $1 billion.2 Investigators stressed the need for cost containment strategies to combat high prices for drug therapies.1According to the study, switching patients to generic IV bortezomib could potentially decrease overall costs related to bortezomib by $300-400 million globally.

Generic bortezomib was first approved by the FDA in January 2018 but can only be administered intravenously, according to the study.1

Previous studies have evaluated the occurrence of peripheral neuropathy and supported the study’s hypothesis that patients who have not developed bortezomib-induced peripheral neuropathy (BIPN) after or during 4 cycles of subQ bortezomib could be switched to IV bortezomib without significantly increasing neuropathy.1

Patients were assessed at a Boston Medical Center Health System hematology outpatient clinic. The study, performed between November 2018 and November 2019, incorporated 15 participants who had completed 4 cycles of SubQ bortezomib, had either grade 1 or no BIPN, and received approval from the hematology/oncology providers and nursing departments. Following provider approval, pharmacists updated the patient’s treatment plan orders to IV bortezomib generic formulation.1 Patients were able to be moved to generic IV bortezomib regardless of indication or dose if the other criteria were met.2

The results found no new cases of neuropathy in their growing data set, effectively demonstrating the potential to replace subQ with generic IV bortezomib.1

“Global adoption of this protocol has the potential to substantially reduce drug costs related to multiple myeloma,” the investigators wrote.1


1. Shah B. Jhaveri R, Sanchorawala V, et al. Successful transition from bortezomib subcutaneous to generic intravenous bortezomib: Cost savings initiative with global economic impact. ASCO. J Clin Oncol 38; 2020 (suppl; abstr e19375). doi: 10.1200/JCO.2020.38.15_suppl.e19375.
2. Jhaveri R, Sanchorawala V, Sloan JM, et al. Successful Transition from Bortezomib Subcutaneous (SubQ) to Generic Intravenous (IV) Borezomib: Cost Savings Initiative with Global Economic Impact. Blood. 2019; 134 (Supplement_1) 4758. doi:

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