Optimizing Transitions to Biosimilars Continued

EP: 1.Optimizing Transitions to Biosimilars

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EP: 2.Optimizing Transitions to Biosimilars Continued

EP: 3.Increased Use of Biosimilars

EP: 4.Transitioning to a Biosimilar Program

EP: 5.Protocols and Laws for Transitioning to Biosimilars

EP: 6.Tracking Usage and Monitoring the Impact of Biosimilars

EP: 7.Integrating Biosimilars for HCPs, into Electronic Health Records, and in Clinical Pathways/Care Plans

EP: 8.Evaluating Biosimilar Programs and Formularies

Ryan Haumschild, PharmD, MS, MBA: Managing inventory, both biosimilar and reference products, is an important part of the job for any pharmacy director. You want to make sure that you always have a drug on hand for your patients, that you’re storing it appropriately, and that you have enough that even if there’s a natural disaster, or if there’s a disruption in the supply chain, you can continue to treat patients. If you’re carrying the reference product and multiple biosimilars, eventually your carrying costs are going to rise. When your carrying costs rise, that means you’re tying up cash and cash equivalents, and days cash on hand that could otherwise be utilized by the organization. We try to look into our treatment plans, look at the amount of treatment plans that utilize the biosimilar, ones that utilize the reference product, and use historical dispense history to determine what’s going to be about 3 to 4 days of inventory on hand. How do we make sure we have enough drugs in all different areas? We try to approve formulary agents as stocked or nonstocked, but with the reference product and the biosimilar, we try to stock both. We’ll stock different quantities for the reference and biosimilars based on our purchase history and the products we have built out within the order sets. That allows us to be operationally effective, but at the same time, reduce our inventory and carrying costs and allow the organization to have that cash and cash equivalents to be used in another area.

When we look at biosimilars in the future, if you would’ve asked me a few months ago, I’d say I’d love to have our first interchangeable product on the market. We know that just got approved. That’s an exciting time. Interchangeability allows the pharmacy to switch out that product without any type of approval, but we have a P&T [pharmacy and therapeutics committee] approval in most places. That’s not as big of an issue. But one of the things that should be a focus is, you’re starting to see many biosimilars come to market, but there’s stratification in the way that each payer prefers biosimilars. So, me at an organization, I don’t want to stock maybe 8 biosimilars for every 1 reference product, so I’m going to try to streamline the biosimilar that I want to keep on hand. I’m doing my due diligence in taking care of organizational resources appropriately. But what the difficult piece is, once I streamline to 1 or 2 agents, if I have 5 different payers and all 5 payers are preferring 5 different biosimilars because they’ve contracted toward 1 specific product, that makes it difficult for me as the health care provider. Now I’ve got to increase my inventory and the number of products across all our different centers to make sure we have enough drugs on hand for the patient. It would be great to create more parity of approval from payers for biosimilars. Organizations, if they’re utilizing a biosimilar, they could have a choice in which biosimilar they stocked, and it would create better approvals in the precertification department and create fewer delays when it comes time for patient care, if the payer comes in with a last-minute denial and preferencing a product that we don’t stock.

My advice for any type of other provider that wants to start a similar program and utilize biosimilars is first do your homework. Do a baseline survey of all your key stakeholders to make sure you understand what are the barriers to biosimilar implementation. I don’t think you can truly be successful in doing this on your own. You need partnership. That’s one of our core values, partnership. You need partnership with the medical team, nursing, finance, managed care, and your local payers to be able to pull this off. Across the different spectrums of those different stakeholders, it’s really important to understand where the biggest concerns lie, so you can do work and educate, work through them, make people feel comfortable with the concepts and the utilization of biosimilars. And not until you get that buy-in will you ultimately be successful. Take the time to plan ahead, get key partnership and buy-in, and start to make decisions through a shared decision-making framework. That’s going to be the way that sticks, and you’re going to need that stickiness and those policies that are approved through oncology P&T to be successful as more biosimilars come to market. There’s more stringency on drug spending and ultimately more payer restrictions coming down the pipeline.

This transcript has been edited for clarity.