Kostas N. Botsoglou, MD, Rheumatology Center of WNY

Providers in rheumatology, dermatology and gastrointestinal disease how they are selecting between the various adalimumab biosimilars available patients.

Selecting Between Adalimumab Biosimilars for Your Patients

This is a video synopsis/summary of a panel discussion involving Jamie T. Brogan, MSN, APRN, FNP-BC; Kostas Botsoglou, MD; Jordan Axelrad, MD, MPH; Sophia Humphreys, PharmD, MHA; and Peter Lio, MD.

The discussion revolves around how to choose the appropriate biosimilar for patients. In dermatology, options are limited, especially for conditions like psoriasis where newer treatments may outperform existing biosimilars. However, for conditions like hidradenitis, where choices are scarce, biosimilars offer a straightforward solution. The growth of biosimilars is anticipated to provide more options for clinicians, allowing them to select treatments based on efficacy and patient insurance coverage.

Clinicians often consider insurance formularies to anticipate the most easily approved biosimilar for each patient. In conditions like inflammatory bowel disease (IBD), certain biologics like Adalimumab play a significant role in treatment, leading to the proliferation of biosimilars. While payer preferences often influence prescribing decisions, clinicians prioritize factors like citrate-free formulations, small volume, high concentration, and robust patient support programs when choosing biosimilars, aiming for broader uptake and patient adherence.

Video synopsis is AI-generated and reviewed by HCPLive editorial staff.

Videos

Providers in rheumatology, dermatology and gastrointestinal disease talk about how they are selecting between the various adalimumab biosimilars available for their patients.

in rheumatology, dermatology, and gastrointestinal disease share strategies in how to increase the uptake of adalimumab biosimilar among providers.

Strategies to Increase Adalimumab Biosimilar Uptake in Clinical Practice

The conversation explores strategies to enhance the uptake of biosimilars, focusing on easing administrative burdens and improving patient access and affordability. Locally, initiatives have been implemented to streamline processes, such as eliminating prior authorizations for renewals of certain medications like adalimumab and reducing copayments for patients. These measures have positively impacted biosimilar uptake in the area.

Strategies for improving uptake include ensuring cost savings for patients, expanding formulary coverage to include more interchangeable products, and enhancing patient education. Patient support programs, including co-pay assistance cards and reimbursement specialists, play a crucial role in promoting biosimilar adoption, especially among Medicare and Medicaid patients. Access to these programs influences treatment decisions alongside considerations of safety and efficacy.

The conversation underscores the importance of balancing cost-saving measures with patient affordability and accessibility. It highlights the complexities clinicians face when navigating the healthcare landscape, where expensive branded medications may be accessible due to support programs, while cheaper alternatives like biosimilars remain out of reach for some patients. Ultimately, addressing these challenges requires a multifaceted approach that considers both systemic cost-saving measures and individual patient affordability.

A clinical pharmacist and specialists in rheumatology, dermatology, and gastrointestinal disease share strategies in how to increase the uptake of adalimumab biosimilar among providers.

A clinical pharmacist discusses the role of pharmacy benefit managers and payers in accessibility of adalimumab biosimilars.

The Role of Pharmacy Benefit Managers and Payers in Accessing Adalimumab Biosimilars

The conversation delves into the role of payers and pharmacy benefit managers (PBMs) in facilitating patient access to biosimilars. PBMs primarily manage formularies, and despite numerous biosimilar launches in the United States, uptake has been relatively low. This is attributed to formulary restrictions imposed by PBMs, leading physicians to prefer biosimilars but encountering barriers due to patient insurance guiding them towards the reference product.

However, there are signs of change, with some large PBMs beginning to cover biosimilars. The trend is encouraging, as biosimilars offer cost savings for both healthcare industries and patients. Despite this, uptake remains low, with only a 2% increase noted by the end of 2023, though there are indications of shifting towards biosimilar usage, especially in Medicare patients.

In New York, for instance, many payers are transitioning towards biosimilars, prompting the need for readiness among patients and providers for potential switches. Pressure is mounting on PBMs to improve formulary access for biosimilars, given the expanding options available and the cost-saving potential, particularly with medications like adalimumab.

Experts talk about the impact of the launch of adalimumab biosimilar on their clinical practices and pharmacy.

Impact of the Launch of Adalimumab Biosimilars in Different Clinical and Pharmacy Settings

The discussion examines the impact of biosimilar launches in both pharmacy and clinical settings. Initially, the adoption of biosimilars was high in oncology, but more conservative attitudes were observed among gastroenterologists and rheumatologists. However, as more data became available, steady uptake occurred, particularly in rheumatoid arthritis (RA), leading to increased comfort among physicians.

In the pharmacy setting, surveys indicate rising comfort levels with biosimilars among healthcare providers, despite initial challenges in determining coverage by insurance payers. The broader availability of biosimilars is expected to potentially lower costs, although the complexity of navigating different biosimilar options remains a challenge.

In the clinical realm, the learning curve for both patients and providers persists, with a focus on understanding coverage policies to avoid delays in treatment access. Education efforts are crucial to ensure patients receive the appropriate medication. In rheumatology, uptake was initially slow due to the availability of unformulated original products, but increased gradually with payer enforcement of switches to biosimilars.

In dermatology, however, the uptake of biologics and biosimilars lags behind other specialties, presenting an opportunity for expansion of treatment options. Overall, improving comfort levels among healthcare providers and early utilization of biosimilars hold promise for enhancing patient care, particularly in stopping disease progression in conditions like inflammatory bowel diseases.

Kostas N. Botsoglou, MD, Rheumatology Center of WNY

Articles