With the impact of the coronavirus disease 2019 (COVID-19) pandemic and its effect on the biosimilar adoption strategy at cancer institutions, almost every patient will be administered a biosimilar based on cost and access, even with the adoption of growth factor utilization, according to the webinar Cancer Care Updates in the Era of COVID-19.

Bhavesh Shah, RPh, BCOP, senior director of specialty, hematology, and oncology pharmacy at Boston Medical Center Health System, mentioned how the cancer care industry has been utilizing biosimilars rather quickly and has been implementing those on a case-by-case basis with patients. The only challenge he has seen is the dependence on payers and which type of biosimilar they are using or, if a biosimilar is not being used, what the brand name product is called.

“Really, our clinical pharmacy team is making sure that it’s implemented across the board,” Shah said. “With the therapeutic biosimilars, and it’s coming to that, that’s been a little bit more difficult. We have utilized or used uptake here for many of our therapeutic biosimilars.”

However, Shah mentioned there is significant pushback from payers, and their institution is doing a lot of work to make sure that patients have access to these medications.

“Patient assistant forms are set up in case they have any changes, and we’ve seen great diligence by the payers, as well, implement those kinds of consistent policies for maintaining a lower co-pay for their patients,” Shah said.

In the ambulatory oncology clinic setting, there has been growth in clinic numbers, as the infusions increase dramatically for patients, according to Ali McBride, PharmD, MS,BCOP, FASHP, FAzPA, clinical coordinator at the University of Arizona Cancer Center. Further, McBride said his clinic is very fortunate to do outpatient chemotherapy for a number of therapies.

“Most of our lymphoma regimens, for example, DHAP, ICE, you name it, we’re doing it outpatient. Even our thiotepa we use outpatient,” McBride said.

Some workflows that McBride’s clinic has adopted for the patient includes telemedicine pieces and transition of care management follow-up.

A topic that has been relevant in the oncology clinic setting has been inpatient discussions and outpatient ambulatory infusions during the COVID-19 pandemic.

“We know that oncolytics are not just one,” McBride said. “It’s not just intravenous (IV), it’s also oral. So, we have a multitude of different types of therapies or combinations in these cases, too, being treated with patients.”

Prior to the pandemic, providers had the option of doing oral or IV infusion. But now, health care professionals are questioning why oral medications would not be an option and other ways of optimizing treatment by limiting the patient’s exposure to potential infection with COVID-19, according to Shah.

“It’s important to note that putting a patient on an oral drug also has risks, because you have adherence, you have toxicities that need to be managed,” Shah said. “And we know there is a lot of data that basically talk about how patients initiate therapy, but within 30 days they actually are off their therapeutic because of so many different reasons.”

Click here to view the full webinar discussion on cancer care during the COVID-19 pandemic.

REFERENCE
Cancer care updates in the era of COVID-19. Pharmacy Times [webinar]. pharmacytimes.com/webinars-webcasts/cancer-care-updates-in-the-era-of-covid-19. Filmed June 22, 2020. Accessed August 3, 2020.