Educating patients, providers improves acceptance, trust as number of approvals, indications grows
Biologic medications are increasingly being used to treat many life-threatening and debilitating diseases, such as cancer, rheumatoid arthritis, and Crohn disease. In recent years, the use of these biologics has increased 12.5% annually, making them the fastest growing segment of the medications market.1 In 2022, 46% of all drug spending was for biologics.1 These medications are usually more expensive than small-molecule chemical medications, but finding lower-cost alternatives for these biologics will help increase access to care for patients.
Fortunately, many biosimilars are available in the US market. Patients in the United States received 6.4 billion prescriptions in 2021, most of which were written for generics and biosimilars. It is estimated that in 2021, generic and biosimilar products saved patients, employers, insurance companies, and taxpayers more than $373 billion dollars.2 Biosimilars are highly similar to brand-name reference products without clinically meaningful differences and offer lower-cost alternatives to expensive brand-name biologics.3
Biosimilars create more competition in the market and help drive down the price of originator biologics. On average, biosimilars are marketed at less than 50% of the originator price, according to a 2022 report from the Association for Accessible Medicines (AAM).2 Biologics with biosimilar competitors have seen a price drop of 25%, on average.2 In addition to improving access for patients, lower acquisition costs also lead to sizable savings for the health care industry. This is welcome relief for an industry which has been strained financially by many factors, including the challenges presented by COVID-19 over the past 3 years. Since the first US biosimilar launch in 2015, more than $13 billion dollars in savings has been associated with the use of biosimilars.2
The lower price of biosimilars also reduces out-of-pocket costs for patients. According to a retrospective analysis of claims data for filgrastim and biosimilars, the introduction of biosimilars in the US market led to both short-term and long-term reduction of patients’ out-of-pocket costs.4 The lower price improved patient access to these lifesaving biologics. Furthermore, AAM reported that biosimilars have been used in 364 million patient days since the first biosimilar launch in 2015. This includes 150 million more patient days of biologic therapy, due to the availability of biosimilars.2
However, biosimilar adoption has been more challenging in the United States than in countries in the European Union and Asia. Many factors have caused this lag in biosimilar adoption, including patient confidence and understanding of biosimilars.5 Pharmacists and physicians are uniquely qualified for patient education regarding the efficacy and safety of biosimilars. Results from a recent survey conducted by the University of Chicago indicated that patients trust recommendations from their physicians and pharmacists when it comes to selecting medications. The researchers surveyed 618 patients receiving biologics with biosimilar competition in the United States and reported that 7 of 10 patients expressed confidence in biosimilars if they had been prescribed by their physicians.6
However, patient understanding of biosimilars is not universal. Among the 608 physicians surveyed in this study, 61% reported low levels of awareness of biosimilars among patients. Furthermore, 40% of the physicians reported that they seldom discuss the benefits and risks of biosimilars with their patients. Interestingly, results from the same survey indicated that 84% of all patients who were prescribed a biosimilar reported that their physicians had educated them regarding the difference between a biosimilar and its originator prior to receiving a biosimilar product.6
Given how much physicians’ opinions influence patient acceptance of biosimilars, provider confidence and knowledge of biosimilars is crucial in building patient confidence. In an interview, frontline physicians Roy M. Fleischmann, MD, and Joel M. Gelfand, MD, MSCE, FAAD, shared how they build patient confidence and improve the patient experience. They explained that physicians need to make a complicated concept understandable in layman’s language. Patients must be reassured that biosimilars are highly similar to the brand-name originators they have been receiving, with no meaningful clinical differences.7 They also pointed out that patient confidence can be built when physicians explain the fundamentals of the mechanism of actions of these products, emphasizing that the biosimilars and originators all work the same way pharmacologically.7
In addition to physicians, patients interact with a multidisciplinary team throughout the course of their care, including nurses, infusion pharmacists, pharmacy technicians, social workers, and lab technicians. Many of these team members can be influential and form trusting relationships with their patients. Educating all these team members and building their confidence in biosimilars may help increase the degree of patient confidence.7
Additionally, biosimilar manufacturers can help increase access to care by providing patient assistance programs. In an interview, Sonia T. Oskouei, PharmD, BCBBS, BCMAS, DPLA, vice president of biosimilars and specialty at Sandoz, explained that US patients are familiar with patient support programs from the originator companies. For biosimilars to be accepted, the manufacturers of biosimilars must offer similar or better assistance to patients. This may take the form of co-pay assistance, assistance with out-of-pocket costs, and programs to help with prior authorization processes. Such programs will help improve treatment adherence and minimize difficulties during the transition from originator biologics to biosimilars.5
By maintaining a patient-centered approach, clinicians can help improve biosimilar adoption. Co-pay assistance, sharing information about payer coverage, and focused and simplified education regarding the efficacy and safety of biosimilars enhance patient confidence and improve biosimilar success. This promises to be an important test year, as the first noninsulin pharmacy benefit biosimilars will be launched, including biosimilars for (adalimumab) Humira.8 With more pharmacy benefit biosimilars coming to the market, patient acceptance of these therapies is going to play a vital role in the health care industry.
About the Author
Sophia Z. Humphreys, PharmD, MHA, BCBBS, is the director of system pharmacy clinical programs and formulary management at Sutter Health in Sacramento, California.