Drs Rebecca Borgert and Jim Rebello Discuss What Could Persuade Payers to Use Biosimilars

Rebecca Borgert, PharmD, BCOP, and Jim Rebello, PharmD, from Magellan Rx Management, discussed what evidence they believe could persuade payers to include biosimilars as preferred formulary products.

Rebecca Borgert, PharmD, BCOP, is the senior director of oncology clinical strategy and innovation and Jim Rebello, PharmD, is the vice president of formulary strategies at Magellan Rx Management.


What sort of evidence might help persuade payers to put more biosimilars on formulary and give them preferred status?

Borgert: That’s what we’re hoping our case study will show when we present at AMCP 2021 on Friday. We feel like we have a pretty persuasive argument that the payers that do not prefer biosimilars and instead have them just on the formulary at parity with the reference products are definitely leaving money on the table. I think if anything will motivate payers to rethink their strategy around biosimilars, I think that will be it.

Rebello: Yeah, totally agree. Case studies and data showing both the uptake and the actual savings instead of theoretical savings—having real-world savings—I think it’s great. Also, showing that the level of provider uptake and embracement that we haven’t had, because of the proactiveness and the level of collaboration, a lot of provider pushback. There has been a lot of noise. So, I think sharing all of that information with payers that maybe haven’t gone down this road yet should encourage more use, not just in oncology, but in any future biosimilar category. We know there’s more coming, probably every year for who knows how long.

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