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25/08/2021 Integrating biosimilars into the healthcare system
US prescription drug prices are rising every year and among them are cancer therapies. In the US alone, the annual cost of cancer care for all cancers is expected to increase from $183 billion in 2015 to a projected $246 billion in 2030.i

Given the high-cost of cancer care, there has been much debate about the cost of cancer therapies as well as how the system can be improved to provide valuable cancer care at a lower cost, without compromising its quality.

And as the hospitals and health systems face unprecedented financial challenges in light of the COVID-19 pandemic, biosimilars can become a viable solution for value-based oncology care. Biosimilars have comparable safety and equivalent clinical efficacy as reference products, and provide additional treatment options for patients, potentially lowering the total cost of care by fostering market competition.ii

One of the successful biosimilar adoption stories often mentioned in biosimilar space is Kaiser Permanente, which is one of the largest integrated healthcare systems in the US. They have achieved approximately 80-95% biosimilar utilization rate within the system, while saving millions of dollars in the process.iii

One of the success factors pointed out by Kaiser Permanente that stands out is ensuring prescriber comfort through biosimilar education and cross-specialty communication, as strong prescriber confidence leads to increased acceptance of biosimilars among patients.iv

When we discuss barriers to biosimilar adoption, one of the challenges often highlighted is the lack of physicians’ confidence in biosimilar’s safety and efficacy, especially when switching patients to biosimilars. Physicians are used to seeing the clinical data for all the indications, while biosimilar studies are intended to establish “biosimilarity” to the reference product, and not intended to independently establish clinical safety and efficacy of the product. The foundation of biosimilar development and approval lies in the extensive analytical assessment, that is, the structural and functional characterization and comparison of the biosimilar versus the reference product.v This different approach to development and regulatory pathway between novel biologics and biosimilars has often caused confusion among physicians.

So, it is important that prescribers understand how biosimilars work and why they are safe to use, and are able to tell what value biosimilars bring from the patient’s perspective. According to Kaiser Permanente, disseminating and generating unbiased information and data about biosimilars to educate clinicians and support treatment decisions has been effective. Close communication and interaction between the physician, nurses, and the patient also helps, as any concern raised by the patient can be addressed and educational messages and toolkits can be improved.iiiiv

Biosimilars are a practical solution to the current health care system in terms of providing physicians and patients more “choice” of medicines that have the comparable quality, efficacy, and safety as the reference medicine, and potentially savings millions of dollars for healthcare systems and practices. As more hospital networks are looking to transition toward value-based care model, it would be beneficial to have more practices share their success stories with biosimilar implementation and the practical solutions to overcoming operational challenges so that other institutions feel more at ease when they start considering biosimilar implementation, including clinical assessment, electronic medical records (EMR) integration, economic assessment, and most importantly, ensuring provider utilization and comfort and patient education.

i. Angela B. Mariotto, Lindsey Enewold, Jingxuan Zhao, Christopher A. Zeruto and K. Robin Yabroff. Medical Care Costs Associated with Cancer Survivorship in the United States. Cancer Epidemiol Biomarkers Prev July 1 2020 (29) (7) 1304-1312; DOI: 10.1158/1055-9965.EPI-19-1534
ii. “Biosimilars.” U.S. Food and Drug Administration website, July 28, 2021. Available at: https://www.fda.gov/drugs/therapeutic-biologics-applications-bla/biosimilars/. [Accessed August 2021]
iii. “Biosimilars at Kaiser Permanente” Kaiser Permanente Institute for Health Policy (KPIHP) website, December 2020. Available at: https://www.kpihp.org/wp-content/uploads/2020/12/Biosimilars_at_KP_121420_FINAL.pdf. [Accessed August 2021]
iv. Welch, Anna Rose. “How Kaiser Permanente Built A Biosimilar Empire ‒ The Inside Story.” Biosimilar Development, February 07, 2020. Available at: https://www.biosimilardevelopment.com/doc/how-kaiser-built-a-biosimilar-empire-the-inside-story-0001. [Accessed August 2021]
v. “Biosimilar Development, Review, and Approval.” U.S. Food and Drug Administration website, July 28, 2021. Available at: https://www.fda.gov/drugs/biosimilars/biosimilar-development-review-and-approval. October 20, 2017. [Accessed August 2021]

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