Accelerating Biosimilar Momentum to Support Sustainability of the US Healthcare System

Healthcare in the US is often a double-edged sword. Recently, it’s gotten sharper at both ends. 

One edge represents the scientific achievements occurring at breakneck speed and with immense benefit for patients. Take biologic medicines, arguably one of the most important advancements of the last hundred years. These innovative medicines have made many types of cancer, colitis, and rheumatoid arthritis treatable conditions for millions of people.

The other edge is overall healthcare spending, which in the US, is on an unsustainable trajectory across almost all healthcare sectors. In 2018, specialty drugs, including biologics, which are highly targeted and effective medicines, represented only 2.2% of all US prescriptions, but more than one-third of net drug spending

One way to help address healthcare cost sustainability, while maintaining access to effective biologic drugs, is through greater adoption and use of biosimilars.  Biosimilars are FDA-approved medicines with the same rigorous quality, safety, efficacy and manufacturing standards as their reference medicines. Biosimilars can expand patient access to life-changing biologic medicines, increase healthcare savings, and have an important role in creating sustainability for overburdened health systems through increased competition. 

Despite their clear benefits, the uptake of biosimilars in the US has been far from ideal.  At the recent Becker’s Healthcare webinar, “Biosimilars: Key Learnings & Opportunities for Greater US Adoption,” I spoke with Dr. Sameer Awsare, Associate Executive Director at The Permanente Medical Group and Christine Simmon, Executive Director at the Biosimilars Council and Senior Vice President, Policy & Strategic Alliances at the Association for Accessible Medicines about why these roadblocks exist and who and what is needed to remove them, especially if the US healthcare system wants to see up to $100 billion in savings by 2024

The first biosimilar – manufactured by Sandoz – was approved fifteen years ago in Europe. Fast forward to now, there are 60 biosimilars successfully approved in Europe, offering insights that the US can learn from to increase uptake. For example, on that side of the Atlantic, the right mix of stakeholder involvement across and between government policymakers, regulators, industry, and patients resulted in increased patient access to treatments and better health outcomes. In addition, institutions in Europe reinvested savings from biosimilar adoption to improve patient experiences with increased hospital staff, shorter waiting times, and simplified administrative processes.

The US healthcare system is significantly different from that of Europe and has its unique complexity at the federal and state level. Nonetheless, Europe illustrates the potential savings and access that biosimilars offer.  In order for biosimilars to achieve their full potential, all healthcare stakeholders – policymakers, prescribers, hospital/clinics, specialty pharmacies, payers, patient groups - should strive to collaborate and communicate across the healthcare continuum.  This includes:

  • Sharing real-world examples of where biosimilars are making an impact: Kaiser Permanente is a case in point. This integrated healthcare network has saved more than $200 million since 2015 by adopting biosimilars, and reinvested these savings to improve patient access and care.
  • Supporting sensible policy: Among the many policies that would help, policymakers should authorize a temporary add-on payment to healthcare providers in Medicare Part B to increase prescribing and use of biosimilars.
  • Combating disparagement and misinformation: Education is a key component to increasing access to, and adoption of, biosimilars for patients in the US. Despite clinical and real-world evidence showing that patients can effectively and safely switch from the reference biologic to a biosimilar, some clinicians remain hesitant to make this change.
  • Ensure formulary coverage of biosimilars to allow patients to access biosimilars at lower out-of-pocket costs in federal and state public and private programs. 

Sandoz is committed to work with every interested party to ensure biosimilars are available, affordable, and accessible to patients, and that payers, patients and healthcare providers recognize their value as life-changing treatment options.

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