Chief Pharmacy Officer of Moffitt Cancer Center Discusses NCCN Biosimilar Recommendations

The Center for Biosimilars® (CFB): I'm Tony Hagen, senior editor for The Center for Biosimilars®. Biosimilars are valuable tools for saving money and improving access to care. But using them requires care in storage, records management, payer interactions and procurement. To help pharmacy teams get this process right, the NCCN [National Comprehensive Cancer Network] Pharmacy Directors Forum put together a set of recommendations on safe and efficient use of biosimilars in the clinical setting. The NCCN forum also called for bringing an end to single biosimilar payer policies, which they feel are too restrictive. We spoke to a co-lead on the paper, Kenneth Komorny, the chief of pharmacy at Moffitt Cancer Center. Dr Komorny worked with a team of 10 others, including Ryan Roux, vice president of pharmacy at the University of Texas MD Anderson Cancer Center.

CfB:When talking about the risks of using biosimilars, in the NCCN paper, you say that you don't mean to discourage the use of these products. More specifically, you want to emphasize the need for attention to detail for doing things carefully. Can you elaborate on that thought?

Komorny: That's absolutely true. By no means did we intend to discourage those products. All of the members on the workgroup support the clinical use of biosimilars with careful attention, as you said, to some of the major risk points that we highlighted. Unfortunately, there's a misperception that no additional work is needed in using biosimilars and that there are really no risks from an operational standpoint of utilizing multiple biosimilars. As highlighted in our paper, that couldn't be further from the truth. There are many moving parts. There's an awareness of those risk points. It's important to establish a solid strategy around those risks to avoid process failures and really to ensure a best practice. So, that was our intention with the paper.

CfB: The pharmacy directors team at the NCCN believes that a legislative solution may be the best answer to payer single-biosimilar policies. Can you explain?

Komorny: Sure. The need to process different brands of the same medication to different patients on the same day leads to risks, as we discussed in the article. When a payer selects only 1 of many biosimilars and they only will pay for that one, and then another payer selects a different biosimilar of that same medication, that truly serves as the root cause to that problem. We have very strong relationships with some of our payers and we negotiate and collaborate on initiatives that are important to them. At the same time, they work with us to assure that we can provide that care in a safe manner. But other times, honestly, there's less interest in collaboration. In those cases, legislation may be necessary to intervene on potentially unsafe policies. So, I guess I wouldn't say that it's the best answer in all situations, but it may be the only answer in certain circumstances.

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