Posters From AMCCBS and AAD Showcase New Technology for Biosimilar Uptake, Barriers to Self-Injectable Biologics

Posters from Association of Cancer Care Centers' 50th Annual Meeting and Cancer Center Business Summit (AMCCBS) and the American Academy of Dermatology (AAD) annual meeting highlight the benefits of incorporating biosimilars into electronic medical records (EMRs) and the biggest barriers for home injection of biologics.

Technology to Help With Biosimilar Substitution¹

Researchers from Flatiron Health found that integrating biosimilar substitution features into EMRs was an effective strategy to help providers ensure quality care for patients with cancer.

Biosimilars are estimated to save the US health care system about $54 billion and cut Medicare out-of-pocket costs by $3.3 billion by 2029. Increasing biosimilar utilization is expected to lead to more savings, and insurers have started implementing preference lists of biosimilars that should be used before other medications in the same drug class.

However, ensuring the appropriate biosimilar is utilized is often a manual process for many community practices, which can be inefficient to maintain over time, resulting in staff burnout and lost cost savings. Pharmacists and practice administrators typically must assess regimens individually and make biosimilar substitutions on a case-by-case basis. The researchers sought to investigate whether technology within EMRs could be used to streamline the process associated with biosimilar substitution and help community practices generate cost savings.

“Ensuring that patients receive the insurer preferred biosimilar is essential to helping community oncology practices receive complete reimbursement for care while helping to also keep the patient’s out-of-pocket cost low,” the authors stated.

Software teams developed an integrated “drug substitution feature” within OncoEMR, Flatiron Health’s EMR, based on user research conducted amongst community oncology practices, showing the need for more technology to:

• Help users identify biosimilars on formulary lists as well as biosimilars that are available to patients
• Allow users to substitute biosimilars based on practice or payer preferences
• Reduce time and effort with manual workflow regarding biosimilars

The results showed that since the feature launched in March 2021, biosimilar ordering increased 20% across the network—from 238,272 to 285,091 orders by the end of the fourth quarter of 2023.

When analyzing bevacizumab products, as more biosimilars entered the market, the number of orders for biosimilars increased and the number of orders for the reference product decreased. The authors said bevacizumab provided an example showing the usefulness of the tool in managing multiple biosimilars for the same reference product.

Overall, no safety incidents were observed, and qualitative feedback from users related to the tool’s convenience, improved workflow efficiencies, and cost benefits. The authors noted that the feature could be useful in helping community oncology practices be more efficient in maintaining and updating insurer preferred preferences as more biosimilars for the same reference agent enter the market.

Additionally, the tool allows for patients to start treatment faster because their payer’s preference list can be incorporated into the EMR feature, which can reduce time associated with prior authorization.

Barrier to Self-Injectable Biologics²

Another study evaluated barriers to self-injectable biologics, which has become a larger topic of discussion since the US market introduction of 9 adalimumab biosimilars in 2023.

Self-injection allows patients to administer their medications quicker than drugs administered in a clinic, offers increased flexibility, reduces costs associated with co-pays and taking time off work, and provides greater control over self-managing their conditions. Although plenty of patients have the option to do at-home injections, many continue to go to the clinic to receive their medications.

Some of the major barriers to self-injection are fear of needles and concerns about pain as well as lack of confidence in their ability to administer the medication correctly.

The researchers conducted a survey to identify barriers and gauge patients’ knowledge bases regarding resources for self-injection. Thirty-five patients who presented to clinic for in-person assistance with drug administration were surveyed from April 2022 to January 2023. Patients were given a 10-question survey by the medical assistant or provider administering the injections.

Nine drugs were evaluated: dupilumab, guselkumab, ixekizumab, secukinumab, adalimumab, etanercept, certolizumab, risankizumab, and tralokinumab.

Results from the survey showed that 60% of patients were not aware of nursing support for self-injection, 43% would use one-on-one nursing support, and 49% were not aware that resources for self-injection were available.

“There is potential to increase rates of at-home self-injection of biologics if the resources provided by biologics manufacturers are utilized,” the authors wrote.

References

1. Speicher S, Wynn F, Ritter K, Hay H. Technology for substituting biosimilars to improve practice efficiency and financial health. Presented at: AMCCBS; February 28-March 1, 2024; Washington, DC.

2. Duarte-Summers A, Hattier G, Jones E. Barriers to home injection of biologics. Presented at: AAD Annual Meeting; March 8-12, 2024; San Diego, CA. Poster 53991.