Dr Scott Soefje on the Role of Biosimilars in Global Drug Spending and Why Interchangeability Is Important

Scott Soefje, PharmD, director of pharmacy cancer care at Mayo Clinic, explains how interchangeable biosimilars are important—especially on the pharmacy benefit side—and serve as another step toward treating biosimilars like generic drugs.

Transcript

What is the predicted global drug spending by 2027?

It's estimated that by around 2027, the total global expenditures will be somewhere around $1.5 trillion. Oncology is probably going to be somewhere around $300 billion of that, and it's estimated that biosimilars will be somewhere in that 15% to maybe 20% range as far as total amount of the oncology biologics. I think it's gonna be a little hard to put an exact figure on what we're going to project by 2027 because some of it depends on uptake, how things change, what new ones come out between now and then. But they're starting to make a significant impact in the overall cost of drugs and that's what they're designed to do.

Why is the interchangeability designation so important for insulin biosimilars, like Rezvoglar and Semglee, for patients with diabetes?

Interchangeability is an interesting concept, and I think it's going to be more important for those drugs that are dispensed through retail pharmacies than they have been for the biosimilars, so far, that have been dispensed in infusion centers. In my institution and in a lot of institutions, we declare biosimilars therapeutically equivalent, and we have the ability to just change them out as we see fit. When you start getting into the retail setting, pharmacists don't have that authority unless they have a collaborative practice agreement with the provider. Interchangeability gives the pharmacist the choice to say, "This is the cheaper drug, this is the one we need, so let's go choose that one." So I think these interchangeables, particularly on the pharmacy benefit side, are going to be very, very important.

[There are] a whole lot of complexities that go along with them, because payers are making a lot of demands, formulary demands. What if the one you choose is not on the formulary? All of those kind of complicated things are going to get in there. But I do think that these new interchangeables are the first step to get us to the point where, from a policy perspective, we start treating biosimilars like generic drugs.