Kyle Herndon1,2, Jason Braithwaite3,4, Brittany Berry3,4, Kathleen Bourget3,4. 1. HealthTrust Purchasing Group, 1100 Charlotte Ave Suite 1100, Nashville, TN, 37203, USA. kherndonrx@gmail.com. 2. University of Tennessee College of Pharmacy, Nashville, TN, USA. kherndonrx@gmail.com. 3. HealthTrust Purchasing Group, 1100 Charlotte Ave Suite 1100, Nashville, TN, 37203, USA. 4. University of Tennessee College of Pharmacy, Nashville, TN, USA.
Abstract
BACKGROUND: Biosimilars represent a significant cost savings opportunity for the entire healthcare system. Despite efforts from the United States Food and Drug Administration, adoption has not been as successful as originally hoped. Perceived barriers to adoption of biosimilars have been described previously, but more knowledge is needed. Further, increased understanding is needed surrounding commercial payer preferences of biosimilars. METHODS: A survey to assess perceived barriers to biosimilar adoption was dispersed to healthcare leaders who work in health-systems, physician practices, and the pharmaceutical industry. Policies from the top 15 commercial payers, by covered lives, were reviewed to collect information surrounding coverage and preferred products to assess if perceptions from healthcare leaders align with payer policies. RESULTS: The largest number of responses (n = 76) came from health-systems (n = 56), followed by pharmaceutical manufacturers (n = 12), and physician practices (n = 8). Responses from each cohort aligned very closely with the composite results of the group. Responses surrounding safety and efficacy were high amongst all groups, while rebate increases to payers for reference products were of highest concern for adoption. United Healthcare had the most policies preferring biosimilars (6/7, 86%). Filgrastim-sndz (Zarxio), had the most preferred statuses for a biosimilar (10/15, 67%). The infliximab reference product had the most preferred statuses for a reference product (9/15, 60%). CONCLUSIONS: Findings from this study outline the greatest perceived barriers to adoption of biosimilars from a variety of different stakeholders. Rebates from reference product manufacturers to payers was the main deterrent for biosimilar use.
BACKGROUND: Biosimilars represent a significant cost savings opportunity for the entire healthcare system. Despite efforts from the United States Food and Drug Administration, adoption has not been as successful as originally hoped. Perceived barriers to adoption of biosimilars have been described previously, but more knowledge is needed. Further, increased understanding is needed surrounding commercial payer preferences of biosimilars. METHODS: A survey to assess perceived barriers to biosimilar adoption was dispersed to healthcare leaders who work in health-systems, physician practices, and the pharmaceutical industry. Policies from the top 15 commercial payers, by covered lives, were reviewed to collect information surrounding coverage and preferred products to assess if perceptions from healthcare leaders align with payer policies. RESULTS: The largest number of responses (n = 76) came from health-systems (n = 56), followed by pharmaceutical manufacturers (n = 12), and physician practices (n = 8). Responses from each cohort aligned very closely with the composite results of the group. Responses surrounding safety and efficacy were high amongst all groups, while rebate increases to payers for reference products were of highest concern for adoption. United Healthcare had the most policies preferring biosimilars (6/7, 86%). Filgrastim-sndz (Zarxio), had the most preferred statuses for a biosimilar (10/15, 67%). The infliximab reference product had the most preferred statuses for a reference product (9/15, 60%). CONCLUSIONS: Findings from this study outline the greatest perceived barriers to adoption of biosimilars from a variety of different stakeholders. Rebates from reference product manufacturers to payers was the main deterrent for biosimilar use.