While commercial payers have been engaged with the shift to biosimilars, they all have their own preferred biosimilar, which makes it challenging for practices, explained Lalan Wilfong, MD, vice president of payer relations & practice transformation at The US Oncology Network.
While commercial payers have been engaged with the shift to biosimilars, they all have their own preferred biosimilar, which makes it challenging for practices, explained Lalan Wilfong, MD, vice president of Payer Relations & Practice Transformation at The US Oncology Network.
What has been your experience with commercial payer contracts on the use of biosimilars? Are they encouraging biosimilar use?
In our experience, commercial payers are wanting to move to biosimilars. Many of them—because of what they do and having to be held accountable to their employers and other people who are buying services from the insurers—they do want to utilize services that lower the cost of care. We have seen a shift to biosimilars for our commercial payers.
I’ll say the challenge with them is that each one of them want to pick a winner that they like, which makes it extremely challenging for a practice to have to shift gears for every patient that walks in the door and use the insurer’s “preferred biosimilar” versvsus just using biosimilars. And we always advocate for physician choice and that if we're going to use biosimilars, let us be able to pick the biosimilar that we want to use so it's much easier on a practice to be able to manage their patient population, rather than having to switch gears with every single patient that walks in the door.