Session Highlights Barriers to Biosimilar Adoption and Lack of Provider, Payer Education

Biosimilars offer a “big shot” at addressing the high cost burdens patients face for drugs, but they still face a number of barriers in the United States, explained Robert M. Rifkin, MD, FACP, medical director of biosimilars at McKesson Specialty Health, The US Oncology Network, during a session at the 2018 Community Oncology Conference, hosted by the Community Oncology Alliance April 12-13 in National Harbor, Maryland.

Rifkin highlighted the current high prices patients have to pay for treatments and that the monthly cost of a new cancer drug is $10,000, and that biosimilars offer an opportunity to address those rising costs with lower-cost competitors.

Despite the promise of reducing costs and increasing access, biosimilars have faced big challenges as the manufacturer of the reference product has fiercely defended the originator, prices haven’t been as low as initially expected, and education among providers and payers remains an issue.

“We’ve been hearing about biosimilars for a number of years, but until now, it has been vaporware,” Rifkin said. With another 2 biosimilars expected to be approved by the end of 2018, the challenges facing biosimilars will need to be addressed.

There is going to be a greater need for payer, patient, and provider education to ensure that biosimilars successfully come to market and are used in place of the more expensive reference product. Rifkin noted that after Zarxio had come to market, 1 payer considered it investigational, despite its having FDA approval. Another payer had decided that patients could only get Zarxio if they failed to respond adequately to Neupogen, despite their being the same drug.

Among providers, medical oncologists appear to the be less educated about biosimilars compared with other specialty physicians. The good news, Rifkin joked, is that despite being the least well educated on biosimilars, they were the most willing to accept their lack of knowledge in the area.

“The reason the education lagged behind is because all of us who are busy oncologists don’t want to hear about something that’s coming in 2019, because I’ll pretty much forget that by the end of the day,” Rifkin said.

Rifkin also ran through the major barriers to adoption, which he broke into 3 categories:

1. Clinical barriers, such as understanding what biosimilars are and whether or not patients can be switched to the biosimilar from the innovator product.
2. Ease of use barriers, such as whether or not payers will cover the biosimilar, whether the biosimilar is a better deal for patients, and whether using the biosimilar will create more hassle for the clinic and patients.
3. Economic barriers, such as the cost to patients and the clinic.

Rifkin predicts that 2018 will be important for biosimilars. In 2017, the Supreme Court eliminated the 180-day waiting period after FDA approval to launch a biosimilar, which means that biosimilars can come to market much more quickly once they’re approved, and payers and providers will need to be ready. However, most importantly, biosimilar makers need to ensure a successful product launch.

“Because if you’re product gets approved, and it sits on the shelf at virtually no discount, that really doesn’t help any of us,” Rifkin said. “I think we’re all looking for deep discounts, we’re looking for transparency...to benefit all of our patients, providers, and stakeholders.”