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Enhancing access to biosimilars in the US involves multiple key factors, including active participation from payers, providers, and the healthcare community to incentivize the utilization of biosimilars.
In the final part of an interview with HCPLive Rheumatology, Juliana Reed, MS, executive director of the Biosimilars Forum, discussed the challenges faced to improve patient access to biosimilars as well as her predictions for biosimilars in the future. This conversation was inspired by a recent report, “Future Evolution of Biosimilar Development by Application of Current Science and Available Evidence: The Developer’s Perspective” published by the Biosimilars Forum earlier this month.
According to Reed, enhancing access to biosimilars in the US involves multiple key factors, including active participation from payers, providers, and the healthcare community to champion and incentivize the utilization of biosimilars.
“Drawing from over 4 decades of small molecule generic utilization, we understand that patients, payers, and providers require incentives to transition to lower-cost medicines,” she explained. “Without these incentives, patients may be reluctant to switch from their current medications to equally safe and effective biosimilars. Pharmacy benefit managers (PBMs) play a significant role, and it's vital for them to reconsider their preference for highly rebated products over lower-cost biosimilars”
An essential point to note is the launch of certain biosimilars with a 2-tier pricing structure. In some instances, the biosimilar is introduced with both a high list price and a high rebate, as well as a low list price and a low rebate. This contrast in pricing highlights the need to address the access and affordability gap. While the biosimilar with a significant discount is available, it often faces barriers to access due to formulary restrictions set by PBMs.
Looking ahead, Reed anticipates significant developments in biosimilars.
“We recognize the commitment made by our forum members, leading biosimilar companies worldwide, to develop high-quality biosimilars adhering to rigorous regulatory standards,” she stated. “Their efforts reflect a dedication to fostering competition, reducing costs, and bringing valuable treatments to patients. However, for the biosimilar ecosystem to flourish, a collective effort from all stakeholders is crucial.”
This transcript was edited for clarity.