Oncology has been an easy area for employers to adopt biosimilars because of the rising costs in the space, said Margaret Rehayem, vice president, National Alliance of Healthcare Purchaser Coalitions. Now that multiple adalimumab (Humira) biosimilars are hitting the US market, employers should take a step back to review their current strategy around the drug.
Oncology has been an easy area for employers to adopt biosimilars because of the rising costs in the space, said Margaret Rehayem, vice president, National Alliance of Healthcare Purchaser Coalitions. Now that multiple adalimumab (Humira) biosimilars are hitting the US market, employers should take a step back to review their current strategy around the drug.
Transcript
The oncology space has the most biosimilar approvals and the greatest uptake right now among providers. Are you seeing comfort levels with using biosimilars vary among employers depending on the disease state?
I think there are some employers that are more comfortable depending on disease state. Some just blanket want to be able to have biosimilars on formulary in general. But I think as the market grows here, the familiarity around biosimilars, that conversation becomes easier for employers, there will be more traction across more disease states. Oncology is an easy one, because employers have really over time wanted to get out of the way, not to have any barriers at all around medications and treatments. But the costs are really rising in that space, too. So, they have to balance affordability.
This year, at least 8—and as many as 10—Humira biosimilars are going to hit the US market. Is there a challenge for employers to manage so much competition hitting all at once?
Yes, is the short answer. And I know you don't want me to stop there. I think employers that were in our learning collaborative, that this was what their number 1 issue, as we're moving into 2023: is what can and should they be doing?
There are a number of strategies that we highlight in our playbook for them to take a look at and consider as they're looking at their strategy. But one of them is really going back and asking their PBM [pharmacy benefit manager] what they're currently looking to do with Humira? What is currently their strategy around that? And does that really fit the employer’s needs?
They almost have to step back a little bit and see what their health plan and PBM are looking to do, and then really put in place what's necessary moving forward. This is not going to be something that is a cookie cutter approach. It's not something that we can say, “Employers just do these 3 things, and you'll be okay.” There are no guarantees here. But what we do want to encourage employers to do is lean in rather than lean back on Humira.
A new study highlights significant disparity in reimbursement rates across states between hospitals and Medicare; the first patient to receive a genetically modified pig kidney has died; research examines outcomes of over 500 patients receiving medication abortion pills by mail.
Read More
Frameworks for Advancing Health Equity: Urban Health Outreach
May 9th 2024In the series debut episode of "Frameworks for Advancing Health Equity," Mary Sligh, CRNP, and Chelsea Chappars, of Allegheny Health Network, explain how the Urban Health Outreach program aims to improve health equity for individuals experiencing homelessness.
Listen
Challenges in developing next-generation cancer therapies persist; research indicates widespread utilization and hurdles in affordability and access to glucagon-like peptide-1 (GLP-1) medications; legislation seeks to legalize therapeutic use of psychedelics in California.
Read More
Tackling Health Inequality: The Power of Education and Experience
April 30th 2024To help celebrate and recognize National Minority Health Month, we are bringing you a special month-long podcast series with our Strategic Alliance Partner, UPMC Health Plan. Welcome to our final episode of this limited series and our conversation with Janine Jelks-Seale, MSPPM, director of health equity at UPMC Health Plan.
Listen
Research Shows Prior Authorization Denials Delay Critical Immunology Care
May 10th 2024Results featured at the Academy of Managed Care Pharmacy 2024 annual meeting revealed a pattern of prior authorization rejections that could delay necessary therapeutic treatments for various patient groups.
Read More
Looking Back on ISPOR 2024: Hot Policy Topics, Welcome Focus on Employers, and More
May 10th 2024Kimberly Westrich, MA, chief strategy officer of the National Pharmaceutical Council, reflects on the most valuable learnings from the 2024 meeting of ISPOR—The Professional Society for Health Economics and Outcomes Research, including lively discussions of the Inflation Reduction Act and workshops on value assessment.
Read More