OR WAIT null SECS
In the second part of an HCPLive Rheumatology interview with Juliana Reed, MS, executive director of the Biosimilars Forum, she explains the factors decision-makers need to consider to ensure lower-cost adalimumab biosimilars reach millions of patients in the United States.
“One of the most crucial steps is for the individuals responsible for paying the bills, such as employers and health benefit providers, to demand the lower-cost biosimilar,” Reed stated. “By advocating for the lower-priced product, they can generate significant savings.”
Additionally, decision-makers should collaborate with pharmacy benefit managers (PBMs), who act as intermediaries in the healthcare system. Working with large employers and trade groups representing millions of Americans can create a powerful voice in support of lower-cost biosimilars.
She believes another important step is for the Medicare program to actively consider the adoption of biosimilars. Currently, Medicare has one of the lowest rates of biosimilar utilization. It is essential for Medicare to prioritize cost savings and support the use of lower-cost products, particularly for Medicare beneficiaries who are often on fixed incomes and burdened by the high costs of medications. By embracing biosimilars, Medicare can unlock cost savings that can be reinvested in the program to improve access and fund new initiatives.
“The broader healthcare community also needs to step up and evaluate whether they are effectively driving down costs, promoting competition, and supporting biosimilars,” Reed emphasized. “By encouraging the adoption of lower-cost alternatives, the community can contribute to reducing healthcare expenses and expanding patient access to affordable treatments.”
Recently, adalimumab-adbm (Cyltezo) was added to the Express Scripts National Preferred Formulary (NPF). Expanding formulary coverage for biosimilars, particularly in the adalimumab space, holds significant importance as preferred status is crucial for the success of biosimilars.
Without preferred status, biosimilars are often perceived as being on the same level as the originator biologic. To encourage physicians and patients to choose and prescribe biosimilars, incentives are necessary. Education plays a vital role, especially when introducing biosimilars to patients with chronic diseases, Reed explained. If patients do not see a financial advantage or budgetary impact in switching to a biosimilar, they may be hesitant to change their treatment. Therefore, achieving preferred status for biosimilars is essential to drive their adoption and utilization.
“Decision-makers should demand lower-cost biosimilars, collaborate with PBMs, advocate for the adoption of biosimilars within Medicare, and ensure the broader healthcare community actively supports lower-cost products,” Reed concluded. “Expanded formulary coverage, specifically preferred status for biosimilars like Cyltezo, is crucial for their success and encourages physicians and patients to choose these cost-effective alternatives.”
This transcript was edited for clarity.