Adam Colborn, JD, director of government relations for the Academy of Managed Care Pharmacy, discussed how providers can comfortably switch patients to biosimilars while minimizing anxieties, as well as the impacts prior authorization requirements can have on patient access.
Adam Colborn, JD, director of government relations for the Academy of Managed Care Pharmacy, analyzed approaches health care professionals can take to reduce patient anxieties when switching from a reference biologic to a biosimilar, and touched on the impact of prior authorization requirements on patient access to medications. Colborn presented at the Academy of Managed Care Pharmacy (AMCP) 2024 annual meeting during a session titled, "Breaking Boundaries With Interchangeable Biosimilars: The Sequel," where he explained the regulatory landscape of interchangeable biosimilars, the outcome they have on formulary management and benefit design, as well as emerging regulatory trends.
As the director of government relations at AMCP, Colborn applies his experience in public policy and advocacy at the federal and state level to support the organization's mission and members.
Transcript
What are some strategies or approaches that health care professionals can employ to alleviate patient anxieties when transitioning from a reference biologic to a biosimilar?
I think it would be most useful for providers to receive additional education around biosimilar switching. I think it's not well understood right now, and there's additional education that can be done to empower providers to better inform their patients.
Right now, I think many providers feel that they don't have the information that they need in order to talk confidently about this with their patients. So, that's part of it, is the provider education. Additionally, thinking about biosimilars as comparable to generics is helpful—I think it's the clearest analogue. Everyone is very comfortable with generics now, but biosimilars are a little bit more recent, so that hasn't quite entered the consciousness the same way that the safety of switching from a brand name small molecule drug to a generic small molecule drug has.
What are your thoughts on the role of prior authorization requirements in the biosimilar space, and how do you believe they impact patient access to these medications?
I think that prior authorization, like other utilization management techniques, there's really no specific way that we can say this will impact utilization except for how it directs patients to whatever is potentially on a lower tier. So prior authorization, I think, is probably less significant than formulary tiers, step edits.
So a step therapy protocol would be more likely to direct a patient toward a lower-cost therapy through a biosimilar before potentially moving to a more expensive innovator product. As far as prior authorization goes, I think, that would primarily be implemented for a safety concern rather than a cost concern.
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