Laura Joszt, MA

When multiple trastuzumab biosimilars entered the US market in quick succession, they were able to do something other biosimilars have not in the United States: drive down the cost of the originator biologic.

Abstracts presented at EULAR 2023 highlighted the impact that a mandatory switching policy had on biosimilar uptake in British Columbia, Canada, and the lack of uptake when no such policy was in place in the United States.

New research has found the 340B program is slowing uptake of biosimilars by incentivizing use of more expensive biologics.

Insurance is by far the most important factor of whether patients followed up with treatment after getting screened for glaucoma, said Byron L. Lam, MD, professor of ophthalmology, University of Miami Miller School of Medicine's Bascom Palmer Eye Institute.

The FDA approved Celltrion Healthcare’s Yuflyma (adalimumab-aaty), which is a high-concentration, citrate-free formulation.

Addressing racial disparities in skin cancer involves education, understanding rates of risk and ethnicity, and knowledge of the different types of melanoma, which makes skin cancer disparities complex to attack, said Sancy Leachman, MD, PhD, professor and chair in the Department of Dermatology and director of the Melanoma Research Program at the Knight Cancer Institute at Oregon Health and Science University.

Gene therapies like RGX-314 are looking to treat very common diseases in ophthalmology, which would represent a tremendous opportunity for chronic disease management, said Charles C. Wykoff, MD, PhD, of Retina Consultants of Texas and the Blanton Eye Institute at Houston Methodist Hospital.

There is a concerted effort to identify biomarkers to understand the risk of progression of diabetic eye disease, but many studies have not been performed in diverse populations, explained Jennifer K. Sun, MD, MPH, associate professor of ophthalmology and chief of the Center for Clinical Eye Research and Trials, Harvard Medical School; and chair, DRCR Retina Network.

Oncology has been an easy area for employers to adopt biosimilars because of the rising costs in the space, said Margaret Rehayem, vice president, National Alliance of Healthcare Purchaser Coalitions. Now that multiple adalimumab (Humira) biosimilars are hitting the US market, employers should take a step back to review their current strategy around the drug.

The DRCR Retina Network is undertaking research to develop preventive strategies for diabetic eye disease, explained Jennifer K. Sun, MD, MPH, associate professor of ophthalmology and chief of the Center for Clinical Eye Research and Trials, Harvard Medical School; and chair, DRCR Retina Network.

Rebates remain very attractive for many employers, but they should push back on the reliance on rebates that may be preventing biosimilars from being added to formularies, said Margaret Rehayem, vice president, National Alliance of Healthcare Purchaser Coalitions.

Gene therapy has the promise of being one and done, but it isn’t always that way for all patients, which leaves questions about where these therapies fit in the commercial landscape, said Charles C. Wykoff, MD, PhD, of Retina Consultants of Texas and the Blanton Eye Institute at Houston Methodist Hospital.

While employers fall on a spectrum when it comes to knowledge and understanding of biosimilars, there does remain a need to educate them, as well as for them to educate their employees, said Margaret Rehayem, vice president, National Alliance of Healthcare Purchaser Coalitions.

Lack of knowledge about how skin conditions present on lightly pigmented skin has resulted in diagnostic delays, underassessment, and an impact on quality of life for patients with skin of color.

Retinopathy of prematurity (ROP) that occurs in preterm babies can progress fast, which requires quick decisions early about treatment, explained Darius M. Moshfeghi, MD, chief, Retina Division, and professor at the Horngren Family Vitreoretinal Center, Byers Eye Institute, Department of Ophthalmology, Stanford University School of Medicine.

Each patient needs to weigh the benefits and risks of genetic testing for melanoma and have someone who can take the time to explain everything, including insurance risks, said Sancy Leachman, MD, PhD, professor and chair in the Department of Dermatology and director of the Melanoma Research Program at the Knight Cancer Institute at Oregon Health and Science University.

The Employer Playbook on Biosimilars highlights strategies employers can use to navigate challenges around ensuring employee access to biosimilars at the pharmacy, as well as how to respond to pharmacy benefit managers who aren’t making biosimilars available on the formulary, said Margaret Rehayem, vice president, National Alliance of Healthcare Purchaser Coalitions.

Not only are Black and Brown communities, as well as neighborhoods with lower socioeconomic status, disproportionately impacted by climate change, but these communities are not as readily able to adapt to mitigate the impacts climate change has on health.

Each trial extension has added new and more data and a better understanding of how ruxolitinib cream treats vitiligo in the long term, explained John Harris, MD, PhD, FAAD, director of the Vitiligo Clinic and Research Center at UMass Chan Medical School.

Many gene therapies promise life-changing effects, but without long-term data it remains to be seen how long the benefits last.

A new report from AHIP indicates that biosimilars have the potential to garner savings of $180 billion over 5 years, but there needs to be a review of the approval process for interchangeability to encourage more approvals.

While there are benefits of gene therapy, some patients will continue to need anti–vascular endothelial growth factor (VEGF) therapy to treat wet age-related macular degeneration (AMD), said Charles C. Wykoff, MD, PhD, of Retina Consultants of Texas and the Blanton Eye Institute at Houston Methodist Hospital.

While the future is bright with potential for personalized medicine to treat atopic dermatitis, current treatment is still more like trial and error, said Emma Guttman-Yassky, MD, PhD, FAAD, of the Icahn School of Medicine at Mount Sinai.

Equity has to be made front and center in conversations about value assessment, otherwise all stakeholders will continue waiting for someone else to make the first move, said one panelist at the Value-Based Insurance Design Summit.

The Protocol AC study analyzed visual acuity gains and cost if patients with diabetic macular edema started on bevacizumab, which costs less, and switched to aflibercept later, explained Jennifer K. Sun, MD, MPH, associate professor of ophthalmology and chief of the Center for Clinical Eye Research and Trials, Harvard Medical School; and chair, DRCR Retina Network.

The province of Newfoundland and Labrador and the territory of Yukon both announced biosimilar switching policies, bringing Canada to a total of 10 out of 13 jurisdictions have a policy in place.

There is a “spectrum” of problems and obstacles in a patient’s way once melanoma has been detected before that patient sees the right physician and receives treatment, said Sancy Leachman, MD, PhD, professor and chair in the Department of Dermatology and director of the Melanoma Research Program at the Knight Cancer Institute at Oregon Health and Science University.

Two posters presented at the American Academy of Dermatology (AAD) annual meeting evaluated misconceptions and addressed concerns around the use of biosimilars in dermatology.

Mental health is an underrepresented issue in dermatology even though numerous skin diseases are associated with mental health diseases, said Eva R. Parker, MD, associate professor of dermatology at Vanderbilt University Medical Center and president of the Nashville Dermatologic Society.

The first FDA-approved therapy for geographic atrophy, pegcetacoplan, slows disease progression but does not reverse it, which means providers need to intervene early before there is too much irreversible damage, explained Eleonora Lad, MD, PhD, associate professor of ophthalmology, Duke University.