Employer Opportunities With Biosimilars - Episode 4
Recommendations for improving utilization of biosimilars and engaging leadership to increase uptake.
Mohannad Kusti, MD, MPH: In terms of recommendations for improving utilization of biosimilars, there are several things that can be done. One is education. We need to educate prescribers, we need to educate patients, and we need to educate the employers and the people who are involved in benefit designs. I think that would be a very good first step. I think a second step is as we educate the people who are designing the plans and managing the PBM [pharmacy benefit manager] formulary, it is important to ask questions about whether these health plans and PBMs are covering biosimilars, the ones that are obviously FDA approved, and what is the utilization? It is also important to ask how they design their plan, whether they’re considered at parity or considered a preferred treatment for certain classes.
These are very important initial steps. As biosimilars start to increase in the market as more in the pipeline are coming in, these discussions will increase. I do believe that if that trend continues and we’re having these active discussions with the PBMs and the health plans, and the education continues with the prescribers and the patients, that’s going to help improve the utilization of biosimilars.
I have to mention that in talking to several teams involved in either utilization, development, or marketing of biosimilars, there is a belief that there’s a window of biosimilar uptake that theoretically, if missed, would mean the US market may never catch up to the rest of the world in regard to the full utilization of the biosimilars.
The question about engaging leadership in organizations to increase uptake is a very interesting one. I have seen, depending on the organization and their leadership, that sometimes if there is mention of biosimilars in the media that is being reviewed by people in leadership in the C-suite, that there is a trickle down to the benefits and the rewards team members to actively engage our health plans and our PBMs to increase uptake, or at least start that conversation. That has been very effective because once you have the buy-in from the leadership, things tend to happen a lot easier and smoothly.
Another way to do it is to try to talk during conferences and various events. There are conferences for CEOs, and there are conferences for CFOs [chief financial officers]. As more of these topics are being brought up in those meetings, particularly discussing the parts about the rebate guarantees, and the potential effect on health care spending, and cost of our plan design, I think this would help an organization engage more in biosimilar utilization and increase uptake.