Expert Discusses Cost Savings Through Biosimilars

Tasmina Hydery, PharmD, BCGP, discusses how stakeholders can maximize cost savings from biosimilars through collaboration. She notes biosimilars' growth in immunology and oncology, where they provide opportunities to leverage the competitive landscape. Real-world evidence on effectiveness and switching, as well as state substitution laws, were cited as important to overcoming adoption barriers. Stakeholders must work cohesively by communicating evidence effectively and managing supply chains well. Including pre-approval data and sharing new evidence can help payers and providers make informed decisions to drive biosimilar adoption and realize potential savings.

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Q: This year, what are some therapeutic areas where biosimilars are going to have the most significant impact in? What does the pipeline look like in these areas?

Tasmina Hydery: So biosimilars today's spanned numerous therapeutic areas including oncology, supportive care, immunology, endocrinology and ophthalmology. We've seen the most growth recently in the immunology space. Since 2023, 10 adalimumab biosimilars have been approved. There's really a tremendous opportunity here for leveraging the competitive landscape. We're already seeing some major players in the health care industry actually make changes as a result of these options. So for example, the VA has selected Hadlima in place of the reference product Humira on their national formulary. Also, as of April 1, CVS actually removed Humira from their major national commercial formularies and the adalimumab biosimilars are now covered. So with that we're actually already starting to see some changes in the prescribing trends. This past year some of the first biosimilars for Tocilizumab and ustekinumab will also be approved, and we're likely going to see their impact in the next year with conversions from reference product to biosimilar. Oncology is another area where we're continuing to see growth with numerous bevacizumab and trastuzumab biosimilars, as we know, the reference products are some of the top grossing products here in the United States in the oncology space. So I'd say the pipeline is really still going strong with more products that are under investigation across several stages of clinical trials. Both in immunology and oncology, there's areas with high specialty pharmacy spend, there's certainly an opportunity for stakeholders to leverage the competitive landscape for cost savings.

Q: What did the 2023 payer and provider survey show on the management and adoption of biosimilars?

Tasmina Hydery:Yeah, I'll start by mentioning that the surveys were fielded to Cencora's Managed Care Network payer panel and the specialty pharmacy network panel of specialists prescribers and they were really intended to help identify how organizations are leveraging biosimilars. To us, the voice of the customer is really crucial to help us better understand the landscape. Now between these 2 surveys, we asked close to 50 questions. So I'll just highlight a few different areas that were impactful. Now ultimately, the goal of biosimilars is to provide cost savings to the health care system. So we asked if biosimilars provided meaningful cost savings, and the majority actually responded that they are so the outlook is positive here and justifies the continued traction being made by biopharma companies and other stakeholders. The second thing I'll mention is with the growth that we've been seeing in biosimilars over the past year as far as approvals and launches, it's not surprising that payers are saying that they're only preferring some biosimilars, rather than all or most. In contrast, when we conducted this survey back in 2021 and 2022, payers said that they preferred most biosimilars. So with more biosimilars overall and more biosimilars per reference product, there are certainly opportunities to just prefer a subset, with price actually emerging as the most impactful factor per survey. Lastly, I'll note when we ask payers and providers what can help overcome barriers to adoption of pharmacy benefit biosimilars, real world evidence on effectiveness and switching and state laws and regulations for substitution came out at the top. So by prioritizing communication and dissemination in these areas, we might actually see some more growth and biosimilars adoption.

Q: What are some real-world examples and evidence that are currently being utilized for biosimilar decision-making?

Tasmina Hydery:Europe, I would say has really been the trailblazers for evidence generation in this space. They have essentially concluded that switching from the reference product to the biosimilar and from a biosimilar to another biosimilar is safe and effectiveness remains unchanged. An organization here in the United States like AMCP's BBCIC have worked with stakeholders to further increase the availability of this data. In the end, I think payers want to do what is most cost effective, what's best for their members and the overall health care system. So this evidence is really instrumental in supporting the use of biosimilars and validating that they provide the same clinical benefit as the reference products.

Q: Is there anything else you would like to add?

Tasmina Hydery:The general theme that really comes to mind for me with biosimilars is that stakeholders need to work together cohesively so we can truly realize the potential for cost savings with biosimilars. So this is everything from providing the evidence communicating effectively and managing the supply appropriately. Payers and providers alike are using numerous data sources for their decision making processes. So including pre-approval information and early engagement by manufacturers and sharing new evidence as it becomes available will really assist in driving that adoption of biosimilars.