Adopting Biosimilars in Clinical Practice

EP: 1.Overview of Biosimilars in Oncology

EP: 2.Interchangeability of Biosimilars

EP: 3.Role of Immunogenicity in Biosimilars

EP: 4.Using Secondary Patents and Skinny Labels

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EP: 5.Adopting Biosimilars in Clinical Practice

EP: 6.Challenges and Management of Adopting Biosimilars

EP: 7.Optimizing P&T Process for Biosimilar Adoption

EP: 8.Overcoming Barriers With Adopting Biosimilars

EP: 9.Challenges for Coverage of Biosimilars

EP: 10.Provider Buy-in and Education of Biosimilars

EP: 11.Impact of COVID-19 on Adoption of Biosimilars

EP: 12.Strategies for Biosimilar Adoption

Bhavesh Shah, RPh, BCOP: What are the challenges in adopting biosimilars in your practice? We have a great mix of panelists: Ryan has the academic perspective. Tim is in New York, where he has his own mecca of cancer center that drives decisions across the country. Brandon comes from the community side, so we’re trying to understand the various dynamics that play a role in biosimilar adoption. We’ll start with Ryan in terms of the challenges seen for biosimilar adoption in the oncology and nononcology space.

Ryan Haumschild, PharmD, MS, MBA: Great question. We’ve had different stories between oncology and nononcology, and I’ll lead with that. Initially, about 3 to 4 years ago, we started having our first biosimilars really integrate the growth factor space with pegfilgrastim. A lot of discussions were coming up with biosimilars. In academic institutions, a lot of physicians and providers were very much against biosimilars initially. They had their opinions. This was for patients in curative state. The thought was, “How could we experiment with their lives with biosimilars?” Oh, has that changed.

Coming from there, we did a survey. We figured out the biggest education gaps in terms of biosimilar adoption. What are things we can focus on? Through time and familiarity, and with help from our payers forcing us to use some biosimilars, our providers got a lot more familiar with utilizing them across this space. For oncology, it’s become very accepted to utilize biosimilars. We’re also being a lot more sensitive to the financial toxicity and total cost of care of value-based contracts that our organization may join in. From that perspective, our providers are on board and have almost deferred to pharmacy at this point through a P&T [pharmacy and therapeutics] proposal to select the most appropriate biosimilar for a patient as long as it’s the same therapeutic drug. That’s been a huge lift for us, and it’s allowed us to be very adaptable and excel the practice of our pharmacy team while being good financial stewards and utilizing biosimilars by carrying costs and therapeutic selection.

But within the nononcology space, it’s been a little slower uptake. When we think of rituximab, it’s used across oncology and nononcology. Oncology providers were more receptive to uptake it, especially in the patient population for hematology. But when we have our nononcology areas, such as gastroenterology and rheumatology, there has been a little more hesitation around switching. There is a little more lack of awareness about immunogenicity data and concerns there. Now there are some rituximab products that come up that have switching data, specifically within rheumatology, and that’s been really helpful to leverage so that we can be a strong utilizer of biosimilars in the oncology area.

Bhavesh Shah, RPh, BCOP: That’s great. You guys are doing some amazing things, and I’m sure that there’s significant adoption across your territory.

Transcript edited for clarity.