Expert: Concerns Around Efficacy of Biosimilars Is Primary Reason for Health Care Professionals’ Hesitancy in Treatment Adoption

Pharmacy Times interviewed Sonia Oskouei, PharmD, vice president of biosimilars at Cardinal Health, on the data presented in Cardinal Health’s 2022 Biosimilars Report, which predicts 2022 will be a turning point in the adoption of biosimilars in the United States.

Alana Hippensteele: Hi, I’m Alana Hippensteele with Pharmacy Times. Joining me is Sonia Oskouei, PharmD, vice president of biosimilars at Cardinal Health, who is here to discuss a 2022 Biosimilars Report from Cardinal Health that predicts this year will be a turning point for biosimilars in the US, and specifically insulin biosimilars.

So, Sonia, what is the 2022 Biosimilars Report and what is the basis for its analysis of the biosimilars market?

Sonia Oskouei: Yeah, so this is a comprehensive report that really brings together latest industry data and insights on biosimilar experiences in the United States both today and what to expect in 2022 and beyond.

Now, Cardinal Health, as an organization, we've been collecting data on biosimilar perspectives and experiences since 2015—the year we had our first approval and launch. Over the years, we've been able to look at trends and monitor the different activities related to these products.

Now, we're essentially approaching this turning point in US biosimilar activity. So we felt it was a really good time to take a pause and reflect on the experiences thus far, really to better prepare for the next wave of biosimilars activity, and while we do this, contribute to the critical need for education around biosimilars in the United States.

Alana Hippensteele: Absolutely. What did the report show regarding biosimilar adoption this year?

Sonia Oskouei: Well, it really showed that we can't generalize biosimilar adoption or activity across all therapeutic areas or even product types. Now what we do know and see is strong adoption and activity with biosimilars, particularly in oncology.

So all 3 therapeutic oncology biosimilars have now exceeded 60% market share, with a strong adoption across oncologists. In fact, some of our survey data revealed that most oncologists feel very comfortable switching from the originator biologic to a biosimilar with their patients.

Furthermore, there's a high level of comfort of even switching between biosimilars in the oncology space. However, when you look at the rheumatology space, despite having our first infliximab biosimilar, available since 2016, we just now exceeded 30% market share for those biosimilars, and you still see quite a bit of hesitation and lack of comfort when it comes to prescribing biosimilars amongst rheumatologists.

In fact, some of the data there show that the top concern with the rheumatologist that we surveyed was efficacy when it came to biosimilars. So it revealed that there's variation in adoption patterns and comfort when it comes to biosimilars.

Alana Hippensteele: So what are some of the challenges connected to the widespread use of available biosimilars?

Sonia Oskouei: Yeah, and this is one where again, we wouldn't want to generalize for each product that still look the same. So it can look different based on therapeutic area of product.

However, if we put them in buckets, we still have the economic considerations and the clinical considerations, I think, at the forefront of barriers to biosimilar adoption.

From an economic or financial standpoint, for example, payer coverage, which includes formulary decisions of reimbursement, continues to be a key consideration and a barrier to biosimilar adoption.

For example, 65% of the rheumatologists that we surveyed strongly agreed or agreed that today, the economics of biosimilars are not favorable enough to motivate a switch from the reference product. So that's a huge statistic right there. So what would be the incentive to switch if there wasn't the economic incentive with these biosimilars? So that is a big part of it.

Clinical acceptance, again, is another barrier when it comes to biosimilar adoption across some of these therapeutic areas. As mentioned with rheumatologists, the top concern still with biosimilars is efficacy. In fact, when we surveyed physicians and endocrinologist as well as pharmacists, their top concern was also efficacy with biosimilars.

Then, in anticipation of the first ophthalmology biosimilar coming to market, retina specialists voted the top 2 concerns for adoption are efficacy and clinical concerns and then payer coverage. So you see the themes throughout where there is hesitancy that you have that clinical in the economics considerations.