Jordan Axelrad, MD, MPH

Clinicians and a pharmacist discuss how they are managing access and assistance with copay assistance program in their practices.

Copay Assistance Programs for Adalimumab Biosimilars

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 conversation delves into the experience with copay assistance programs for biosimilars, highlighting the need for effective patient support to ensure broad uptake and continued adherence. Participants note the familiarity with existing programs for originator drugs and stress the importance of replicating similar support systems for biosimilars to maintain patient confidence.

Concerns arise regarding gaps in education and communication from biosimilar manufacturers, emphasizing the necessity of comprehensive support programs and clear communication channels. Patient access to biosimilars is seen as crucial, with biosimilar adoption programs needing to address various factors such as coverage, support systems, and pharmacoeconomic considerations.

The discussion underscores the significance of accessible and efficient support systems, both for insured and uninsured patients, to facilitate biosimilar adoption. Additionally, effective communication among healthcare providers, specialty pharmacists, and patients is highlighted as essential for navigating access to these programs and ensuring optimal patient care.

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

Videos

Healthcare providers in inflammatory diseases talk about the role they have on encouraging adalimumab biosimilar use in clinical practice.

The Role of Health Care Providers on Encouraging Adalimumab Biosimilar Use

The discussion centers on how healthcare professionals can promote the use of adalimumab biosimilars and enhance patient care. The consensus is that biosimilars offer comparable efficacy and safety to the originator drug, with improved accessibility for patients. Encouragingly, dermatologists, among others, are being urged to consider these options for their patients.

Healthcare professionals emphasize the importance of patient education and cost savings as key factors in promoting biosimilar adoption. Educating both providers and patients about biosimilars, including their regulatory approval process and safety profile, is essential for widespread acceptance. Financial considerations, such as copay savings, also play a significant role in patient decision-making.

Overall, the aim is to assure patients of the efficacy and safety of biosimilars and to equip healthcare providers with the knowledge needed to support their use effectively.

rheumatology, dermatology and gastrointestinal disease share their clinical experience on initiating or switching their patients on adalimumab biosimilars.

Clinical Experience With Initiating Adalimumab Biosimilars

The discussion revolves around experiences initiating patients on biosimilars. For bionaive patients, the process is generally smooth, often involving in-office injections to familiarize patients with administration techniques. However, stable patients may express hesitancy, primarily due to concerns about cost. Educating patients about copay programs and assisting them in enrolling in financial assistance programs can alleviate these concerns.

Transitioning patients to biosimilars can be challenging, especially concerning logistical issues like insurance coverage and medication delivery. Clear communication and proactive enrollment in support programs are essential to prevent treatment interruptions.

Patient education is crucial to address concerns and dispel misconceptions, particularly regarding the nocebo effect. Consistency in messaging across healthcare staff is emphasized to build patient confidence.

Practical strategies for patient education include using lay language, keeping explanations concise, and repeating key information to reinforce understanding. Healthcare professionals also play a vital role in promoting biosimilar use and improving patient care through ongoing education and support.

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

Specialists in rheumatology, dermatology and gastrointestinal disease share their clinical experience on initiating or switching their patients on adalimumab biosimilars.

rheumatology, dermatology and gastrointestinal disease discuss the evidence on efficacy and safety on switching patient to an adalimumab biosimilar.

Switching From Adalimumab to a Biosimilar

An expert discusses the safe transition of patients from a reference product to a biosimilar. He emphasizes that although biosimilars may not be identical, they are sufficiently similar in every parameter. The primary concern during transition is ensuring coverage, as issues with insurance approval can disrupt medication supply. Preparing samples and ensuring insurance approval beforehand can prevent such interruptions.

Proactive patient education is crucial, as the speaker’s practice informed stable patients in advance about potential manufacturer switches. This preemptive communication helped patients anticipate changes and maintain confidence in the effectiveness and safety of the new product.

Another physician emphasizes the importance of patient education, particularly regarding the "nocebo effect" associated with biosimilars, which can lead to unnecessary treatment withdrawal. Educating patients about potential logistical challenges and reassuring them about product safety is essential.

Consistent education across all healthcare staff is emphasized to build patient confidence and prevent misinformation. Patient concerns about efficacy and safety can be addressed by reviewing clinical data and reassuring them of the equivalence of biosimilars to reference products.

Logistical challenges, such as ensuring timely medication delivery, are highlighted as critical for patient safety, as interruptions in treatment could lead to loss of disease control. Bridging programs and support services can help mitigate these logistical concerns and ensure continuity of care during transitions.

Specialists in rheumatology, dermatology and gastrointestinal disease discuss the evidence on efficacy and safety on switching patient to an adalimumab biosimilar.

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

Selecting Between Adalimumab Biosimilars for Your Patients

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.

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

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.

discuss clinical trials that have shown safety and efficacy of adalimumab biosimilars in inflammatory diseases.

The Safety and Efficacy of Adalimumab Biosimilars in Inflammatory Diseases

The discussion shifts to the safety and efficacy of biosimilars across various inflammatory diseases. The VOLTAIRE-RA trial, featuring an approved interchangeable biosimilar, demonstrates safety, tolerability, and efficacy within predefined primary endpoints, extending to conditions like psoriatic arthritis, ankylosing spondylitis, and uveitis. Biosimilars have also gained approval for psoriasis and hidradenitis suppurativa, indicating their versatility across disease states.

The conversation highlights the reassuring performance of biosimilars across different populations and conditions, underscoring their equivalence to originator drugs. Data from randomized trials show comparable patient outcomes and safety between originator and biosimilar therapies, providing clinical reassurance.

Extrapolating findings from one disease area to another, like from rheumatoid arthritis to inflammatory bowel diseases or psoriasis, enhances clinical accuracy and accessibility. With nearly a decade of biosimilar experience, studies consistently demonstrate no loss of efficacy and robust safety profiles, as evidenced by FDA data encompassing various therapeutic areas, including oncology and immunology.

Overall, the accumulated evidence fosters confidence in biosimilar use in the United States, supporting their integration into clinical practice across a spectrum of inflammatory diseases.

Specialists in rheumatology, dermatology and gastrointestinal disease discuss clinical trials that have shown safety and efficacy of adalimumab biosimilars in inflammatory diseases.

A clinical pharmacist reviews the various pharmacological aspects of the available adalimumab biosimilars.

The Pharmacological Aspects of Adalimumab Biosimilars

The discussion delves into considerations regarding the concentration, citrate-free nature, and volume of adalimumab, particularly in the context of transitioning patients to biosimilars. The speaker emphasizes the importance of minimizing patient discomfort by opting for agents with smaller syringes, no citrate, and lower volume. They highlight the popularity of citrate-free products due to reduced pain and mentions that high concentration with citrate may cause less injection site discomfort. Ideally, biosimilars should offer high concentration, small needles, and be citrate-free, although not all currently meet these criteria. Various delivery mechanisms impact patient experience, necessitating education and informed choices.

The speaker adds insights from a dermatological perspective, noting patient preferences for specific pen devices and potential implications for treatment adherence. He suggests tracking patient feedback to inform future decisions. Concerns about off-label doses and the burden of multiple devices underscore the need for streamlined options to facilitate adherence.

The complexity of managing multiple devices and formulations requires extensive patient and staff education. Providers must navigate diverse product landscapes to ensure optimal treatment experiences. The discussion underscores the need for comprehensive understanding and support to facilitate informed decision-making and improve patient outcomes.