Biosimilar Perceptions Among Healthcare Professionals and Commercial Medical Benefit Policy Analysis in the United States

Herndon, Kyle; Braithwaite, Jason J.; Berry, Brittany; Bourget, Kathleen

doi:10.1007/s40259-020-00463-6

Cited by 15 publications

(11 citation statements)

References 8 publications

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“…Most physicians and practice managers interviewed believed biosimilar efficacy and safety to be similar or equivalent to that of the reference products—a belief that did not differ by practice setting—and reported being comfortable using biosimilars for all FDA-approved indications, including extrapolated indications. Our findings were consistent with those from a survey administered among US healthcare professionals, which found that 88% of respondents recognized FDA-approved biosimilars as safe and efficacious and 78% agreed that extrapolation across indications was also safe and effective [ 24 ]. Also, another study showed that approximately 95% of surveyed US community oncologists were very or somewhat confident that biosimilars were as safe and effective as their reference products [ 15 ].…”

Section: Discussionsupporting

confidence: 88%

Evolving Perceptions, Utilization, and Real-World Implementation Experiences of Oncology Monoclonal Antibody Biosimilars in the USA: Perspectives from Both Payers and Physicians

et al. 2021

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Background The adoption of oncology biosimilars has been slow in the USA, which may be attributed in part to stakeholder perceptions and lack of operational guidance that supports favorable access to biosimilars. Objective Our objective was to understand the real-world implementation experiences with oncology biosimilars of US payers and healthcare professionals (HCPs) as their experience with biosimilars has evolved. Methods In-depth qualitative interviews with payers (n = 20) and HCPs (n = 17 physicians, n = 3 practice managers) were conducted. Payers included managed care organizations (MCOs), integrated delivery networks, and pharmacy benefit managers (PBMs). Physicians were affiliated with a healthcare network or were community based, specialized in hematology/ oncology, and had prescribed oncology biosimilars. Audio transcripts of the interviews were coded using MaxQDA software to enable descriptive analysis of the qualitative data. Results Over 80.0% of physicians perceived the efficacy and safety of biosimilars to be highly comparable to that of originators. Up to 87.5% of physicians reported using biosimilars in > 50% of their treatment-naïve patients and were comfortable using biosimilars in all approved indications. To encourage utilization, 75.0% of MCOs/PBMs preferred biosimilars over originators in treatment-naïve patients and implementation via step therapy. Physician involvement in choosing biosimilars was minimal, which was largely dependent on practice protocols or insurance preferences. The major factor influencing payers' coverage decisions and biosimilar adoption was potential cost savings. Conclusions US payers and physicians who have experience with biosimilars have favorable views of oncology biosimilars, particularly for treatment-naïve patients. A framework for integrating biosimilars into oncology practice is developing, primarily driven by insurance coverage, contracting, and cost benefits.

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Section: Discussionsupporting

confidence: 88%

Evolving Perceptions, Utilization, and Real-World Implementation Experiences of Oncology Monoclonal Antibody Biosimilars in the USA: Perspectives from Both Payers and Physicians

et al. 2021

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“…Another survey, conducted to assess perceived barriers to biosimilar adoption in the United States among health care leaders, physician practices, and the pharmaceutical industry, noted that responses from each cohort were closely aligned. 15 Prevalent common concerns regarding adoption among all groups included safety and efficacy and rebate increases to payers for reference products. 15 In summary and to date, the overall experience with therapeutic oncology biosimilars has identified several barriers beyond those that have been observed with supportive care oncology biosimilars.…”

Section: Addressing Biosimilar Concerns and Knowledge Gapsmentioning

confidence: 99%

“…15 Prevalent common concerns regarding adoption among all groups included safety and efficacy and rebate increases to payers for reference products. 15 In summary and to date, the overall experience with therapeutic oncology biosimilars has identified several barriers beyond those that have been observed with supportive care oncology biosimilars. These barriers, in turn, are sustaining the reluctance of health care providers to promote, prescribe, and implement the use of biosimilars into clinical practice.…”

Section: Addressing Biosimilar Concerns and Knowledge Gapsmentioning

confidence: 99%

Section: Addressing Biosimilar Concerns and Knowledge Gapsmentioning

confidence: 99%

“…15 Prevalent common concerns regarding adoption among all groups included safety and efficacy and rebate increases to payers for reference products. 15…”

Section: Addressing Biosimilar Concerns and Knowledge Gapsmentioning

confidence: 99%

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Use of Biosimilar Medications in Oncology

Nahleh

Lyman

Schilsky

et al. 2022

JCO Oncology Practice

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PURPOSE: The increased number and expanded utilization of biosimilars raise important considerations for their safe and appropriate use in oncology practice. This report provides an update on currently approved oncology biosimilars and identifies current knowledge gaps in the management of patients with cancer. METHODS: An Expert Panel was convened to review the medical literature and to provide a practical summary of currently approved biosimilar therapeutics for cancer treatment or supportive care in the United States. RESULTS: A total of 17 cancer or cancer-related biosimilar products have been approved by the US Food and Drug Administration since 2015. Despite years of clinical experience with oncology biosimilars, variance in their use persists. ASCO supports that biosimilars and reference products are considered equally efficacious for the purpose of inclusion in ASCO clinical practice guideline recommendations. CONCLUSION: The use of biosimilars might provide competitive, lower-cost alternatives to biologics used in cancer care, and specific mention in ASCO guidelines and other evidence products is supported where appropriate.

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Obstacles to Biosimilar Acceptance and Uptake in Oncology

Mroczek,

Hauner,

Greene

et al. 2024

JAMA Oncol

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ImportanceBiosimilar drugs provide cost-effective yet clinically indistinguishable replications of target drugs. During initial development, this class of biologic medicines was expected to revolutionize pharmaceutical markets; however, following US Food and Drug Administration approval of the first biosimilar drug in 2015, the commercialization of biosimilars has been limited. The lack of biosimilar use may be especially salient in oncology, given that biosimilar distribution in this particularly high-cost area of medicine would bring savings on the order of many billions of dollars.ObservationsWhile researchers have focused on salient economic barriers to biosimilar uptake in the US, the present review provides insight regarding noneconomic barriers. This review discusses psychological, attitudinal, and educational factors among both health care professionals and payers in the US that may play a role in slowing biosimilar uptake. More specifically, these factors include a lack of health care professional education, concerns of safety and efficacy, and overly complex product naming systems.Conclusions and RelevanceThe pathway to biosimilar use has been obstructed by economic elements as well as attitudinal and psychological factors. For biosimilar drugs to achieve their potential in decreasing treatment costs and thus increasing patient access, it will be essential for both economic and noneconomic factors to be identified and systematically addressed.

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Biosimilar Perceptions Among Healthcare Professionals and Commercial Medical Benefit Policy Analysis in the United States

Cited by 15 publications

References 8 publications

Evolving Perceptions, Utilization, and Real-World Implementation Experiences of Oncology Monoclonal Antibody Biosimilars in the USA: Perspectives from Both Payers and Physicians

Evolving Perceptions, Utilization, and Real-World Implementation Experiences of Oncology Monoclonal Antibody Biosimilars in the USA: Perspectives from Both Payers and Physicians

Use of Biosimilar Medications in Oncology

Obstacles to Biosimilar Acceptance and Uptake in Oncology

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