Preferred Positioning of Biosimilars a Powerful Lever for Adoption, Says Dr Fran Gregory

Payers and pharmacy benefit managers (PBMs) can have a huge impact on the widespread adoption of biosimilars in the US through the favorable placement of biosimilars on formularies, ideally in a preferred position over the reference product, said Fran Gregory, PharmD, MBA, vice president of emerging therapies, Cardinal Health.

At the 2024 Asembia Specialty Pharmacy Summit, held April 28 to May 2 in Las Vegas, Nevada, Gregory presented on biosimilars and how the savings accrued from their use can help fund expensive, innovative therapies to treat complex and life-threatening conditions. She was joined by her colleague, Jerrica Mathis, vice president of government relations, Cardinal Health; and Travis Tate, PharmD, vice president of formulary and trend solutions, CVS Health.

Transcript

What strategies need to be employed for successful, widespread adoption of biosimilars to realize the promised cost savings of these products?

When I think about some of the levers that need to be pulled or modified to allow biosimilars to really come to market more broadly, there are a few different areas. One would be on the provider side. So, the physicians and the nurses and the pharmacists who are prescribing or administering these medications, they have to be confident in the biosimilar safety, efficacy, and the clinical effectiveness of these products. The confidence that the providers have really is directly translated to the confidence that the patient has in their treatment. I think that's really step number one, is making sure that anyone prescribing biosimilars, dispensing biosimilars, [or] managing treatments for patients understand the value of biosimilars from a cost perspective, an access perspective, and a sustainability perspective. I think that's kind of key number one.

Then the second thing, of course, we can't talk about biosimilars without talking about formularies and preferred drug lists. I think that payers and PBMs placing biosimilars in a favorable position on formularies is absolutely critical. The other piece when we think about placement of biosimilars on formularies or in preferred position, really a lot of what we're seeing currently is those biosimilars are being placed at parity or in the same level of access as the reference product. I think we're seeing that that is maybe not as effective of an approach as placing a biosimilar in a higher tier or more accessible tier as far as preferred position within formularies.

I think it's a really exciting time and that we are seeing some PBMs and payers move a little bit more towards biosimilars being in preferred positioning versus parity, so I think we will continue to see more of that. But we have seen that as definitely one of the most powerful levers in biosimilar uptake and adoption specifically on the pharmacy benefit side.