Optimizing Biosimilar Treatment Strategies in Bone Health

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Videos

Jeffrey Curtis, MD, MS, MPH, provides expert perspective for navigating the evolving treatment landscape of osteoporosis and key considerations for biologic and biosimilar utilization.

Managing Treatment Strategies for Osteoporosis Amid Evolving Biologic and Biosimilar Landscape

Insights From Cencora's Lakesha Farmer: Innovative Biosimilar Adoption Strategies

Lakesha Farmer, PharmD, MBA, senior director, strategic accounts, ION Oncology Practice Network at Cencora, explains new strategies being used to incentivize biosimilar adoption and market competition in a world where reimbursement and rebate policies cater more towards innovator products.

Can you discuss any innovative pricing and reimbursement models that have been implemented to incentivize biosimilar adoption and market competitiveness?

Sure, since the introduction to the market, we've seen some very unique pricing incidences strategies created to incentivize adoption of biosimilar agents. So, most recently, we've seen manufacturers take a nonbranded and branded approach to the launch of their biosimilars, which offers a low wholesale acquisition costs are WAC and the high WAC option. This pricing approach is currently being seen with insulin biosimilars and adalimumab biosimilars.

For example, the adaIimumab biosimilars Cyltezo was initially launched as a branded, high WAC product that offer about 5% discount to the originator (Humira). The makers of Cyltezo saw that the uptake of the medication was pretty slow, and that not all PBMs [pharmacy benefit managers] and insurers were receptive to adding the slightly discounted medication to their formularies. So, about 3 months after their launch, the manufacturer decided to launch an unbranded, low WAC version of the medication, which was surprisingly about 81% less than the originator product's price. So, by taking this low WAC/high WAC approach to pricing, this caters to all PBMs and issuer plans based upon their preference and increases coverage and access to biosimilar for patients.
The only possible downside to this pricing strategy that I can possibly foresee is that the heavily discounted low WAC options could possibly impact a manufacturer's ability to offer co-pay assistance programs and other patient access resources.

The second unique pricing strategy that incentivizes patients access to biosimilars is the Mark Cuban Cost Plus Program. This program aims to lower patient out-of-pocket costs by offering your Yusimry, an adalimumab biosimilar, to patients for a low cost of $569 [per month]. According to Drugs.com, the average cash price for Humira is about $7,300. As you can see, by offering this biosimilar at a cash price of $569 to uninsured patients, as well as a possible option for commercially insured patients with high deductibles, co-pays, and/or co-insurances can definitely be a game changer.

Now moving on to address the unique reimbursement incentive. Currently, the most notable incentive is the add-on payment for physician administered biosimilars that was introduced under the Inflation Reduction Act. Under this provision biosimilar reimbursement is set at ASP [average sales price] plus 8% of the reference product's ASP, which is higher than the reference product's reimbursement, which is set at ASP plus 6%. This higher reimbursement rate, provided through Medicare, provides community based providers with a greater incentive to use biosimilars for their patients.

Lakesha Farmer, PharmD, MBA, from Cencora discusses innovative pricing and reimbursement models incentivizing biosimilar adoption and competitiveness, including dual pricing strategies and the Mark Cuban Cost Plus Program, while highlighting potential impacts on patient assistance programs.

Insights From Cencora's Dr Lakesha Farmer: Innovative Biosimilar Adoption Strategies

Top 5 Biosimilar Articles for the Week of May 20

 stressed the need for patient-centered communication and education to boost comfort with biosimilars, emphasizing consistent support from health care providers despite restrictive payer policies.

 Because of differences in how national authorities that manage drug pricing and reimbursement view health technology assessment (HTA) tools for biosimilars, there’s an urgent need for agencies to issue clear guidance on when and how to conduct HTAs for biosimilars, according to a 

 the first 2 biosimilars referencing Eylea (aflibercept)—Yesafili (aflibercept-jbvf) and Opuviz (aflibercept-yszy)—for the treatment of ophthalmic conditions.

 on patients with inflammatory bowel disease (IBD) switching to infliximab or adalimumab biosimilars found no change in clinical remission or antidrug antibodies after 24 weeks, but 13% experienced the nocebo effect, leading to one-fifth discontinuing therapy.

 from the Academy of Managed Care Pharmacy’s annual meeting provided hope that despite low uptake so far, adalimumab biosimilars can deliver on the promise of comparable safety and efficacy with the originator in multiple disease states as well as cost savings.

To read all of these articles and more, visit 

Here are the top 5 biosimilar articles for the week of May 20, 2024. 

The Top 5 Biosimilar Articles for the Week of May 20

Colin C. Edgerton, MD, discusses key considerations for utilizing biosimilars in the bone health treatment landscape.

The Top 5 Biosimilar Articles for the Week of May 13

As Indian pharmaceutical companies supplied 4 of every 10 prescriptions in the US in 2022, generating $1.3 trillion in health care savings, a new 

 highlights concerns about supply chain risks and advocates for partnerships to bolster biosimilar security and overall supply chain resilience.

 Cordavis, a CVS Healthspire company, released a 

 detailing the current hurdles faced in developing and commercializing biosimilars in the US and highlighting efforts by the organization to enhance access and affordability for these products.

 summarizes the product attributes of reference and biosimilar adalimumab products, such as formulation with or without citrate, delivery volume, and needle gauge, relevant to patients’ experience of injection-site pain.

 Biosimilars offer a promising path to affordable, effective treatment, but barriers remain for underserved communities. This 

 explores the potential of biosimilars to improve health equity while addressing the obstacles that currently prevent access.

Here are the top 5 biosimilar articles for the week of May 13, 2024. 

Jeffrey Casberg, RPh, MS. 

Jeffrey Casberg, RPh, MS, senior vice president of pharmacy at 

 mentions several drugs due to lose patent exclusivity soon, which would allow generic versions to be produced. Casberg discusses biosimilar competition, a relatively new phenomenon in the pharmaceutical industry that could lead to significant price reductions.

He highlighted various types of medications, ranging from oncology treatments, to diabetes, inflammatory diseases, and age-related macular degeneration. Casberg suggests stakeholders remain vigilant of these patent expirations in the upcoming year or couple of years as he and other experts work to analyze and determine drug life cycle insights to predict future market shifts.

With brand patents expiring, which products about to face upcoming generic and biosimilar competition do you think stakeholders should be keeping their eye on?

Yeah, there are a couple products coming down the road that would be losing exclusivity. The first one I'll hit is 

 [liraglutide], it's a GLP-1 [inhibitor]. You can't talk about pharmaceuticals today without talking about GLP-1 [inhibitors] and weight loss.

So, Victoza was kind of a big advance back in its day. It was the first once daily GLP-1 [inhibitor], once daily subcutaneous administered injectable product. It has less nausea associated with it than its previous predecessor, 

 [exenatide]. It was also the first GLP-1 [inhibitor] that had cardiovascular positive studies for cardiovascular effect. Great drug but I don't see it really helping with this whole GLP-1 [inhibitor] shortage and weight loss issue.

 [dulaglutide], they both have about 50% the weight loss that 

 [tirzepatide] have so I don't see all of a sudden a big rush to go to Victoza generic because number 1: it's once a day, and number 2: it doesn't have the weight loss that some of the big products that you're hearing about every day have. So, that's Victoza, that'll be coming shortly here in June. I think there could be quite a few generics.

 [dasatinib]. They're both tyrosine kinase inhibitors similar to 

 [imatinib mesylate], great drugs in oncology, pretty expensive therapies, and we should get quite a few generics and a good amount of price reduction there.

Then moving over to the biosimilars side, 

 [ustekinumab] biosimilars are coming. Everybody's been talking about 

 [adalimumab] and 9 or 10 companies bringing those [biosimilars] to market but almost just as big, Stelara is a big drug—$15 to $20 billion product—and it also has 8 or 9 manufacturers lined up to bring products to market. We'll have to see if the adoption by payers is similar or quicker, we're just starting to have some success and conversion of Humira to biosimilars. We'll have to see how the payers adopts Stelara [biosimilars]. Maybe they've gained some more confidence and learned a little bit from the Humira introduction. We'll have to see and Stelara will be coming early in 2025. Amgen has the first product out but then pretty quickly thereafter, several other products will hit.

 [aflibercept] biosimilars in the ophthalmology area, for age-related macular degeneration. We had 

 [ranibizumab] biosimilars come out with a couple of biosimilars recently and those biosimilars have done pretty well.

Eylea, we're watching, we don't know if it's going to come out this year, or in a year or 2. There's an opportunity this year, but IPD, the company I work for does a lot of predicting of this and we think it actually may not be in 2024, it might be 2025 or 2026 before we get Eylea, but watch for that. I had mentioned Victoza, Trulicity is a $16 billion GLP-1 [inhibitor], and it's biosimilar [could be] out in 2027. Something to plan for by the payers.

Jeffrey Casberg, RPh, MS, examines upcoming generic and biosimilar competition in the pharmaceutical industry, showcasing certain drugs that will face competition soon. 

Jeffrey Casberg Predicts Generic, Biosimilar Competition in the Pharmaceutical Market

Expert providers in inflammatory diseases provide additional resources on biosimilars and adalimumab biosimilar for patients and providers.

Resources for Patients and Providers on 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 various educational resources utilized both by healthcare providers and patients regarding ddalimumab biosimilars. Providers emphasize the importance of authoritative sources such as the FDA and professional societies like the American College of Rheumatology for accurate information on interchangeability and biosimilars.

While some providers note a lack of comprehensive resources, they highlight the American Academy of Dermatology and New Zealand DermNet as useful references. Patient education materials from organizations like the Crohn's and Colitis Foundation are also recommended.

Providers stress the need for proactive patient engagement and filtering information from reliable sources, discouraging reliance on social media or blogs for medical advice. To ensure patient understanding, nurses play a crucial role in creating educational tools and facilitating communication, including preemptive notifications about changes in medication availability.

Overall, the discussion underscores the importance of ongoing education and communication between healthcare providers and patients to optimize treatment outcomes with Adalimumab biosimilars.

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

Providers in inflammatory diseases discuss the instrumental role nurses and support staff play in educating patients on adalimumab biosimilars.

The Role of Nurses and Support Personal in Educating Patient on Adalimumab Biosimilars

The conversation centers on the crucial role of nurses and support staff in educating patients and ensuring optimal outcomes with adalimumab biosimilars. Nurses are highlighted as key educators who interact closely with patients, providing training on device usage and addressing any issues that arise. Support staff, including specialty pharmacists and biologics coordinators, also play essential roles in managing patient concerns, such as delays in medication delivery or copay assistance.

Providers emphasize the importance of patient education from the outset, including information on risks, side effects, and access to copay assistance programs. Proactive patient engagement is encouraged, with patients urged to communicate any issues promptly to facilitate timely resolution.

Collaboration between healthcare providers, pharmaceutical companies, and support staff is crucial in navigating the complexities of insurance coverage and product availability. Open communication and ongoing education ensure that patients receive comprehensive support throughout their treatment journey, despite potential changes in coverage and policies over time.

discuss the most asked questions and common concerns patients have on adalimumab biosimilars.

Common Questions From Patients About Adalimumab Biosimilars

The dialogue revolves around patient education regarding biosimilar medications, focusing on common questions and concerns raised by patients and healthcare providers. Cost emerges as a primary concern for patients, with inquiries centered on out-of-pocket expenses and affordability. Providers emphasize the importance of addressing cost-related anxieties to ensure patient access and adherence to treatment.

Furthermore, patients often express apprehension about the efficacy and safety of biosimilars compared to originator drugs. Providers aim to alleviate these concerns by providing comprehensive education on the data supporting biosimilar efficacy and safety, highlighting studies and addressing questions about immunogenicity and device changes.

Another key discussion point is the management of patients who report problems after switching to biosimilars. Providers stress the need for thorough evaluation to differentiate between true treatment failure and potential psychological factors influencing patient perception. Strategies include objective assessment of disease activity and consideration of alternative treatment options based on clinical evidence.

Overall, the dialogue underscores the importance of patient-centered communication, comprehensive education, and evidence-based decision-making to optimize the transition to biosimilar medications while ensuring patient satisfaction and therapeutic success.

Drs Lio, Botsoglou, and Alexrad discuss the most asked questions and common concerns patients have on adalimumab biosimilars.

The Top 5 Biosimilar Articles for the Week of May 6, 2024. 

 showed some misalignment in payer coverage of granulocyte colony-stimulating factor (G-CSF) biosimilars, highlighting that while filgrastim biosimilars are often favored over the originator, reference pegfilgrastim still dominates over its biosimilars.

The FDA approved a high-concentration, citrate-free version of Boehringer Ingelheim’s 

, making it the second high-concentration adalimumab biosimilar to have an interchangeability designation.

 The approval marks the sixth for a biosimilar referencing 

 for the treatment of HER2-positive breast and gastric cancers.

 During her presentation during Festival of Biologics USA, 

, PharmD, director of formulary management at Sutter Health, gave an overview of current challenges and opportunities for the biosimilar market and offered calls to action for multiple stakeholders.

Here are the top 5 biosimilar articles for the week of May 6, 2024. 