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WHEN CHOICE ARRIVES: Competition & Consequences

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BIOSIMILAR APPROVALS

Skylar Jeremias is the Managing Editor for The Center for Biosimilars and The American Journal of Managed Care (AJMC).

Articles

Italian study finds most MS patients start biosimilars unaware, exposing education gaps and highlighting MS nurses as key to boosting trust and uptake.

Low Biosimilar Awareness in MS Patients Points to Critical Gap in Nurse-Led Education

New EULAR guidelines speed RA treatment switches as rheumatoid arthritis biosimilars and cost savings push earlier biologics use.

Biosimilar Expansion, Lower Costs Drive Shift in RA Treatment Guidelines

Dr. Cyrus Karkaria is President of Lupin's Biotechnology Businesses, leading the company's global biosimilars portfolio with over 30 years of biologic drug development experience at organizations including Biogen, CuraGen, and Celldex Therapeutics. He holds a post-doctorate from Harvard Medical School and a PhD. from the University of Maryland.

The FDA has approved ranibizumab-hkdz (Ranluspec; Lupin Limited) as an interchangeable biosimilar for wet AMD, DME, DR, RVO, and mCNV.

FDA Approves Ranibizumab-hkdz as First Interchangeable, Available in Both Vials and Prefilled Syringes

Evidence shows biosimilars switching in ankylosing spondylitis maintains disease control with biologics, cuts costs, and highlights nocebo risks.

Biosimilar Switching Maintained Disease Control in People With Ankylosing Spondylitis

The Center for Biosimilars connects professionals with insights on biosimilars, health economics, regulatory outcomes, and emerging treatment paradigms.

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Business & Practice

 focuses on the critical issue of cost-related nonadherence in biologic treatments and the role of biosimilars in delivering promised savings. Despite the FDA approving 68 biosimilars, they currently make up only 2% to 3% of the U.S. biologics market, with market share varying significantly between individual markets, ranging from 8% to 82%.

Biosimilars have, however, demonstrated significant cost savings over the past decade. According to data from the Association for Accessible Medicines (AAM), generics and biosimilars collectively saved the U.S. a total of $445 billion by the end of 2023. Biosimilars alone accounted for $12.4 billion in savings in 2023, bringing total savings to $36 billion since their introduction in 2015. Despite these savings, barriers remain, as many biologics set to lose patent exclusivity in the coming years lack biosimilars in development. Addressing cost-related nonadherence and leveraging artificial intelligence (AI) to streamline prescribing processes and increase biosimilar utilization are key topics of discussion.

Josh Canavan, head of pharmacy at RazorMetrics, provides insights into why, despite the substantial savings biosimilars offer, they still represent only 23% of the overall biologics market. The conversation explores how AI-powered tools are assisting physicians in transitioning to biosimilars, enabling patients to access life-saving treatments at a fraction of the cost. As the 10th anniversary of the first biosimilar approval is observed, the discussion highlights the importance of automation, policy reforms, and increased adoption to bridge the affordability gap and expand patient access to these critical treatments.

To learn more about the 10th anniversary of the first FDA biosimilar approval and current insights into the biosimilar industry, 

To learn more about how much biosimilars have saved so far, 

To read more about Josh's views on the pharmaceutical landscape in 2025, 

Despite saving billions, biosimilars still account for only a small share of the biologics market—what's standing in the way of broader adoption and how can artificial intelligence (AI) help change that?

How AI Can Help Address Cost-Related Nonadherence to Biologic, Biosimilar Treatment

This episode of Not So Different explores the possible implications of the Federal Trade Commission's (FTC) second interim report on pharmacy benefit managers (PBMs), which shed light on key issues with current PBM practices and their impact on drug prices. The report highlighted several troubling strategies, such as many cases where the big 3 PBMs were reimbursing their own affiliated pharmacies at higher rates than independent pharmacies. The report's latest findings raise important questions about the future of drug pricing transparency and regulation and challenge the notion of whether PBMs are delivering on their intended promise to benefit the health care system.

To help unpack these findings and their implications, The Center for Biosimilars

 was joined by Joe Wisniewski, an expert in PBM legislation, price transparency, and health care policy. Joe serves as assistant vice president of partnerships and government affairs at Turquoise Health and brings a wealth of insight into how PBMs are navigating the current landscape, especially with the rise of new biosimilars and shifting regulatory pressures.

This episode also explores how a second Trump administration could influence PBM practices, particularly in relation to biosimilars, and what that means for drug pricing efforts moving forward.

To learn more about the FTC's most recent report on PBMs, 

To learn more about the FTC's first report on PBMs, 

To learn more about health care actions taken by the second Trump Administration during it's first month, 

To learn more about the views of Mehmet Oz, MD (more commonly known as Dr. Oz) on price transparency ahead of his congressional confirmation hearings as President Trump's nominee for HHS Secretary, 

On this episode of Not So Different, we explore the Federal Trade Commission’s (FTC) second interim report on pharmacy benefit managers (PBMs) with Joe Wisniewski from Turquoise Health, discussing key issues like preferential reimbursement, drug pricing transparency, biosimilars, shifting regulations, and how a second Trump administration could reshape PBM practices.

Will the FTC Be More PBM-Friendly Under a Second Trump Administration?

On today's episode, we'll dive deep into the US biosimilars market landscape, a topic of growing importance as biosimilars offer significant potential for reducing health care costs and increasing access to life-saving therapies. Understanding the current legislative and regulatory environment is crucial, as it shapes the approval and adoption processes for biosimilars. We'll explore key factors affecting payer uptake and provider adoption of biosimilars in the US, such as economic considerations, clinical evidence, and market dynamics. These factors are vital for stakeholders aiming to effectively navigate the complex biosimilars landscape. Additionally, we'll examine the challenges and opportunities associated with biosimilars for stakeholders across the health care continuum, including manufacturers, payers, providers, and patients. Addressing these challenges and leveraging opportunities can enhance the impact of biosimilars on health care systems and patient outcomes, making this discussion essential for anyone involved in the health care industry.

Today, we're joined by Kyle Noonan, PharmD, MS, is a highly qualified expert who supports scientific and commercial consulting engagements at Cencora, helping manufacturers demonstrate the clinical and economic value of their products. His work includes outcomes research strategy, pre-approval information exchange, payer value proposition development, primary market research, pricing research, and market access strategy.

Dr. Noonan has a diverse background with experience in various health care settings, including medical affairs within the biopharmaceutical industry, association management, consulting, and clinical trial research. He has extensive leadership experience with the Academy of Managed Care Pharmacy (AMCP) and has presented numerous posters at AMCP conferences. Dr. Noonan holds a Doctor of Pharmacy from Mercer University and a Master's in Pharmaceutical Outcomes and Policy from the University of Florida.

To learn more about Cencora and their efforts, 

To learn more about the Inflation Reduction Act's impact on biosimilars, 

Join us as we explore the complexities of the US biosimilars market, discussing legislative influences, payer and provider adoption factors, and strategies to overcome industry challenges with expert insights from Kyle Noonan, PharmD, MS, value & access strategy manager at Cencora.








Biosimilars in America: Overcoming Barriers and Maximizing Impact

At Asembia 2023 in Las Vagas, Nevada, Tasmina Hydery, associate director of Digital Solutions at AmerisourceBergen, presented on the future of the biosimilars industry as well as how payers have responded to the influx of new biosimilar products in the United States. During the session, she shared results from AmerisourceBergen's report on the biosimilars pipeline, sharing survey results on how payers place biosimilars on formularies, their views on interchangeability, and their use of prior authorization and step therapy strategies to encourage providers to prescribe preferred products.

On today's episode, we spoke with Tasmina and her colleague, as well as a returning guest on the Not So Different podcast, Brian Biehn, senior director of Biosimilar Commercialization at AmerisourceBergen, about some of the points brought up during the presentation and some of the pricing trends that we're seeing in the space.

To learn more about Tasmina's Asembia 2023 presentation, 

AmerisourceBergen Biosimilar pipeline report

To listen to Brian's past appearance on Not So Different, 

Asembia

On this episode of Not So Different, Tasmina Hydery and Brian Biehn from AmerisourceBergen discussed results from a recent survey, that were also presented at Asembia 2023, diving into the payer perspective on biosimilars and current pricing trends across the US biosimilar industry.

What AmerisourceBergen's Report Reveals About Payers, Biosimilar Pricing Trends

With 1 adalimumab biosimilar and 3 infliximab biosimilars on the market, and over 10 more biosimilars for rheumatoid arthritis (RA) coming down the pipeline, rheumatologists are about to have more treatment choices for their patients than ever before. 2023 marks the US introductions of biosimilar referencing Humira (adalimumab) and Stelara (ustekinumab). With an abundance of choice, come storage, education, and payer challenges. What can practices do to prepare? How can they boost uptake of these products? And how can we ensure that the lower than anticipated uptake of infliximab biosimilars is not repeated?

Today, I’m speaking with Robert Zutaut, RPh, clinical specialist with McKesson Provider Solutions about the influx of these RA biosimilars and actions that clinicians can take to prepare for the large number of products expected to hit the market in the next couple years. Prior to his work with McKesson, he served as the director of pharmaceutical services at Raleigh Regional Cancer Center in Beckley, West Virginia. He obtained a bachelor of pharmacy from West Virginia University and has been analyzing RA biosimilar trends and the everchanging market. He’s also been keeping an eye on the development for prognostic biomarker tests in the RA space.

To learn more about biosimilars to treat RA, 

To learn more about rheumatologists’ perceptions about RA biosimilars, 

To learn more about incentives for prescribing biosimilars, 

To learn more about infliximab biosimilar adoption, 

To learn more about the influx of adalimumab biosimilars to the US market, 

To learn more about ustekinumab biosimilars, 

Keep a lookout for Robert's upcoming contributor article on the developing RA biosimilar market.

What can practices do to prepare for all the biosimilars to treat rheumatoid arthritis (RA) coming down the pipeline? And how can they ensure that the lower-than-anticipated adoption rates for infliximab biosimilars are not repeated? Robert Zutaut, RPh, from McKesson Provider Solutions, tackles all this and more on this episode of Not So Different.

Pipelines and Preparation: How the US Can Prepare for More RA Biosimilars

Although the oncology space is well-known for having the most successful biosimilar uptake, there are barriers that remain. Community oncologists and patients still have to reckon with pharmacy benefit manager (PBM) and payer formulary decisions, incentives for prescribing reference products, and inflated drug prices. However, community oncology practices have a unique opportunity to help boost biosimilar adoption and create savings for patients.

Today, I’m joined by Mark Guyot, senior director of unity provider engagement at McKesson, to discuss some best practices for biosimilar implementation in community oncology practices. Mark worked on creating and conducting McKesson’s real-world analysis that identified challenges and provided necessary support and education for successful biosimilar adoption. The analysis also led to changes within community oncology practices, resulting in significantly decreased care costs for patients, as well as annual cost savings to Medicare, totaling over $164 million.

To listen to our podcast with Cheryl Vaughn, vice president of clinical services at McKesson, discussed how McKesson's Intrafusion service helps manage infusion sites and aids in the administration of complex biologic drugs, including biosimilars, 

On this episode of Not So Different, Mark Guyot, senior director of unity provider engagement at McKesson, gives an overview of McKesson’s real-world analysis of community oncology practices and their use of biosimilars and offers advice on overcoming adoption barriers and expanding education efforts.

How Community Oncologists Can Break Down Biosimilar Adoption Barriers

Recently, Vizient, a member-owned health care consulting company, published the Winter 2023 edition of its Pharmacy Market Outlook Report. The report commented onthe current trends of the biosimilars market, including the impact that inflation and the COVID-19 pandemic are having on biosimilar utilization and drug prices as a whole. It also discussed the hotly-anticipated US launches of upwards of 8 biosimilars referencing Humira (adalimumab) that are expected throughout 2023 and how issues surrounding payer preferences and white bagging policies could influence the uptake of these products.

On this episode of Not So Differet, we spoke with Carina Dolan, PharmD, MS, BCOP, senior director for clinical oncology and pharmaceutical outcomes at Vizient. Prior to her role with Vizient, she served as a hematology and oncology clinical pharmacist at Baylor University Medical Center. In the past, she’s written for 

®, the written journal associated with our sister site AJMC.com, on the current opportunities and challenges for oncology biosimilars as well as how practices can evolve to better manage expensive immunotherapy options.

To learn more about Vizient’s Pharmacy Outlook Report, 

To read Dr. Dolan’s paper “Opportunities and Challenges in Biosimilar Uptake in Oncology published in 

To read Dr. Dolan’s paper “Evolving Practices in Managing Costly Immunotherapy” published in The American Journal of Managed Care®, 

On this episode of Not So Different, Vizient’s Carina Dolan, PharmD, MS, BCOP, expounds on some of the results from Vizient’s recent edition of its Pharmacy Market Outlook Report, including how inflation could influence biosimilar utilization.

On the Come Up: What Vizient’s Report Says About Inflation and Biosimilars

On this week’s episode, we’re discussing the stresses that practices and clinics face when trying to manage biosimilars as well as some policy considerations that administrators should keep in mind as more biosimilars enter the market and more payers add them to formularies.

I am joined by Kathy Oubre, MS, CEO of Pontchartrain Cancer Center, and a member of The Center for Biosimilars® Advisory Board. She is an expert on the administration and practice perspective of managing biosimilars and has extensive experience supervising a practice that has had to adapt to the growing body of oncology biosimilars that have launched on the US market.

To read more of Kathy’s thoughts on the practice perspective regarding biosimilars, click 

To learn more about automatic substitution policies, click 

To learn more about some of the challenges clinicians could face next year as adalimumab biosimilars enter the market, click 

To learn more about prescription behaviors regarding biosimilars, click 

To listen to another podcast episode on a tool that can improve infusion center efficiency, click 

In this podcast episode, Kathy Oubre, MS, CEO of Pontchartrain Cancer Center, discussed the stresses that practices and clinics face when trying to manage biosimilars as well as some policy considerations that administrators should keep in mind as more biosimilars enter the market and are added to formularies.

Order of Operations: Managing Biosimilars While Maintaining Operational Efficiency

On this week’s episode, we’re taking a look at the impact clinical teams have on biosimilar utilization and patient care within infusion centers. Many infusion medications are biologic drugs and juggling multiple biosimilars for the same reference product can place undue burden on infusion centers and result in medication errors, such as accidentally administering a product not covered by a patient’s insurance. Intrafusion by McKesson’s full management service enables better efficiency within infusion centers and relieves some of the pressure providers and administrators face when trying to manage infusion facilities, including leveraging biosimilars.

Today, I’m joined by Cheryl Vaughn, vice president of clinical services at Intrafusion by McKesson. She has worked closely to develop a robust develop the tool clinical nursing program that accompanies Intrafusion’s full management service and has been with the company for over 5 years. She also has over 8 years of experience working as a registered nurse prior to her time at McKesson.

To learn more about McKesson’s Intrafusion, 

To learn more about biosimilar storage concerns, 

Cheryl Vaughn, vice president of clinical services at McKesson, discussed how McKesson's Intrafusion service helps manage infusion sites and aids in the administration of complex biologic drugs, including biosimilars.

Tools of the Trade: How Intrafusion by McKesson Improves Infusion Center Efficiency, Biosimilar Utilization

On this week’s episode, we’re breaking down the possible impact that Humira biosimilars will have on health policies across the United States. Come 2023, the United States will welcome at least 7 biosimilars referencing Humira (adalimumab) to the market, catapulting the adalimumab market to the number 1 spot as the biosimilars space with the most competitive products referencing the same molecule. One of the biggest concerns regarding these launches is how providers, practices, and payers are going to adapt to ensure that patients have access to adalimumab biosimilars and that practices aren’t overwhelmed trying to keep up with multiple versions of the same product.

The Center for Biosimilars spoke with Chronis Manolis, senior vice president of pharmacy at UPMC Health Plan. He has a lot of experience working in the health plan space, especially regarding policy and relationships with pharmacy benefit managers, a rather contentious topic in present day biosimilar discussions. Manolis is also a proponent of the idea that providers and payers could work together to promote biosimilar use and has been keeping eye on the developing adalimumab space.

To learn more about the hype regarding adalimumab biosimilars in the US, 

To see which biosimilars have been approved by the FDA, 

To read more on PBMs and their influence on biosimilar uptake, 

On this podcast episode, The Center for Biosimilars spoke with Chronis Manolis from UPMC Health Plan to discuss how health care policies may shift as adalimumab biosimilars referencing Humira come to market in 2023, including how providers and payers can ensure equitable access.

Not So Different: How Health Policies May Take Shape in a Post-Humira-Exclusive Adalimumab Market

Evidence suggests that adoption of oncology biosimilars in Medicare value-based payment models has produced substantial cost savings and improved provider financial performance.

Biosimilar Adoption and Provider Performance in Medicare Value-Based Payment Models

A phase 2 trial showed that combining targeted radiotherapy with PD-1 blockade and a bevacizumab biosimilar can elicit responses in advanced liver cancer.

Biosimilar-Backed Triplet Regimen Shows Feasibility in Heavily Pretreated Liver Cancer

Switching from aflibercept to ranibizumab biosimilars maintains stability in nAMD treatment, offering a cost-effective solution for long-term management.

Real-World Study Finds Stable Vision After Switch to Ranibizumab Biosimilar

GBW 2025 webinar

Health care systems around the world are facing increasing challenges—from rising costs to gaps in access. Biosimilar medicines offer a promising solution, helping make care more accessible, affordable, and sustainable for patients everywhere. These goals align closely with the United Nations’ Sustainable Development Goals for Health by 2030, and today’s discussion will explore how biosimilars can help make that vision a reality.

This webinar is part of the sixth Annual Global Biosimilars Week, running from November 3 to 7, 2025. The theme this year—“Biosimilars: A Wise Investment for Global Health”—perfectly captures the spirit of this conversation and the opportunities ahead.

, senior director of biosimilar policy and science at Medicines for Europe (moderator)

, global lead, Non-Communicable Diseases, PATH Coalition

, clinical pharmacist (Endocrine/Diabetes) at the Endocrine Institute at Hospital Putrajaya in Malaysia

, director of regulatory affairs at Sandoz Mexico

, director of thought leadership at IQVIA

, oncologist at the University Hospital Bristol NHS Foundation Trust in the UK

, senior advisor in the Division of Access To Medicines and Health Products (MHP) for the World Health Organization (not shown)

These were questions asked by the audience during the live broadcast of the webinar. The speakers provided responses after the webinar ended. Below are their responses and insights.

Are there examples of biosimilar-driven access improvements that could be replicated in other regions?

There are examples available in the IGBA Biosimilar Access Policy Blueprint (2021) as well as in IGBA Biosimilar Communication Resources (Module 5 - The benefits of biosimilar medicines). Translating the biosimilar availability opportunity into tangible access development is always a matter of policy framework and policy interventions that transform the cost-effectiveness gains into investment in better use of resources and more efficient processes.

The 2024 NCD Best Buys report aims at supporting WHO member states to prioritize and scale up the implementation of the most impactful and feasible interventions in the national context. Off-patent medicines, including biosimilar medicines, are part of the best buys. Could you tell us more about the overall progress so far to meet the 2030 goals? (Are we on course? Are we delayed?)

The target established by WHO is for 80% availability. While there has been movement, it is not even across all regions and also varies between the private and public sectors, with private sector availability being slightly higher. The ranges are 38-68% in the public sector and 42% to 77% in the private sector. Some of the challenges are high prices, where many countries pay higher amounts than the international reference price, including both acute and chronic conditions, and where also there is increasing dependency on out-of-pocket payments.

In Mexico, will the government be adopting a streamlined biosimilar development pathway that removes the requirement for phase 3 (comparative efficacy) studies?

Currently the requirements by the local rules include the requirement for clinical trials to demonstrate efficacy and safety. In Mexico, the biosimilars are called biocomparables. Below there is more detail about it.

In my experience, the requirements related to clinical trials are case-by-case; in the end, the opinion of the New Molecules Committee and Biotech Products Evaluation Subcommittee (NMC/BPES) will determine the specific requirements for approval of each biocomparable biotechnological medicine. This opinion is based on the documentation presented in the CTD modules 2, 3, 4, and 5. During my presentation, I also mentioned that for biosimilars, the presubmission meeting before NMC/BPES is mandatory.

For biosimilars, below I have described some preclinical and clinical requirements indicated in the local rules, but this can be extended case by case:

“...The application must include the documentation outlined in Sections I to IX of Article 177, as well as preclinical and clinical studies such as:

Any other studies determined by the Ministry, based on the opinion of the New Molecules Committee.”...

“...III. Reports of preclinical studies in animals must include comparative data between the reference biotechnological medicine and the biocomparable product. These studies must be conducted in relevant animal species and include, as determined by the New Molecules Committee:

Comparative pharmacokinetic study reports, when required by the Ministry, to demonstrate pharmacokinetic biocomparability between the biocomparable and reference products, based on key parameters.”...

How many biosimilar products have been approved through reliance pathways in Mexico so far?

This data is not available. However, in my presentation I mentioned that during almost 4 years the reliance applied to participate in tenders without MA issued by COFEPRIS, applicable only for tenders to supply public institutions Therefore, some products that participated with MA issued by recognized authorities could be identified during the tender processes (small molecules and biosimilars), but there is no official data about the total number of biosimilar products approved through reliance pathways.

In the future, probably based on the last publication in July 2025, for the application of the abbreviated regulatory pathway (equivalence agreements), the approvals might be differentiated.

Regulatory convergence is improving among EMA, FDA, and WHO, but not all dossiers will meet these new standards.Will companies need to conduct new studies, and how might that affect costs or timelines?

 entitled “Developing a Regulatory Policy Framework Supporting Biosimilar Competition: The Opportunity for Tailored Clinical Biosimilar Development” where 2 important points were made:

A global regulators roadmap towards streamlined biosimilar development program should be adopted - maintaining the scientific and regulatory rigor is needed to support approval, and allow for tailored clinical development.

The role of regulators extends beyond approval to include education for healthcare professionals to understand the analytical science that underpins biosimilarity, ensuring that regulatory approval translates to utilization of biosimilar medicines.

Today, in 2025, both remain cornerstone to harvesting the benefits of streamlined development. The asynchrony of adoption of the new standards will require developers to at best maintain extended developments (including unnecessary studies) or worst to have 2 developments for the different jurisdictions, although this is unlikely to be retained as a viable option. This points to all international regulatory convergence initiatives (eg, ICH, IPRP, ACCESS consortium) as key drivers for access.

A significant evolution of the regulatory requirements in underway in the global regulatory community (so called streamlined clinical development) offering the perspective of biosimilar developments for more biologic medicines. How can the WHO efforts be amplified, notably in promoting harmonisation of standards (through the guidelines and their implementation) or through collaborative or reliance initiative?

: If anyone is not familiar with the WHO Prequalification of medicines programmes, I would strongly encourage them to spend some time reviewing the resources and information on the Prequalification website as I am personally on the policy side of the Health Systems Division. In the space of collaboration, the Prequalification programme runs the Collaborative Registration Procedure (CRP) for medicines, vaccines and health products that have been prequalified by WHO. The CRP allows for participating regulators to request, with participation of the manufacturer, the reports and information that were submitted to WHO for regulation for use in considering national market authorizations.

In addition, the concept of regulatory reliance is also advancing through the use of a global benchmarking tool, where countries will be able to develop reliance schemes-based products manufactured under the supervision of recognized regulator. WHO also supports the implementation of WHO biosimilars guidelines in Member States. From November 26 to November 28 in Tunis, WHO will host an implementation workshop for regulators from Africa and the Eastern Mediterranean region, where experience and regulatory frameworks for biosimilars are still developing. This initiative is part of WHO’s ongoing work to promote harmonization and strengthen regulatory capacity globally.

How can we maintain industry sustainability if biosimilar medicines prices drop very quickly in multiple regions?

 Sustainability of the biosimilar business is linked to the overall functioning of the framework: there are many variables. Market competition is an inherent part of the follow-on medicines’ business. The starting points for all biosimilar medicines benefit is to have a multisource market where biosimilar medicines are used, and uptake is significant.


Are African CDC–equivalent agencies considering adding biosimilar medicines into pooled procurement mechanisms?

With the creation of the African Medicines Agency and the pilot 

, there are opportunities for biosimilar medicines developers with biosimilar medicines recognized under the Priority Medicinal Products Category 1 of interest besides facilitating national authorization of the products and strengthening the regulators network, this will without any doubt support translation of approvals into actual market uptake.

WHO is investing in good practice sharing for procurement among WHO member states yet, it feels that there remains an awareness gap among procurers, assimilating biosimilar medicines with generic medicines. This can lead to an impossible match between demand and supply. What can be done to bridge this gap?

 WHO is, as we are speaking today, convening a Forum for procurers to consider priority best practices for the future. Ensuring quality of medicines using procurement as a lever is one area that has already emerged as a priority.

Another one is transparency into markets, which has a benefit for buyers and also for sellers. The more transparent tender information becomes, for example, the more sources the buyer will be able to attract. Sellers also benefit from improved visibility into markets, which we have understood anecdotally is a challenge in the NCD space. Developing pooled procurement mechanisms is also an area that can supply market entry, which is important in the uptake of biosimilar medicines.

It’s great to hear examples of improved access—but why isn’t this type of data more often published in peer-reviewed journals?

 an interesting example of improved and early access is that of a Dutch Research Team lead by Lizzy De Ridder in the context of the 

. The study aimed at making better use of the available treatments for children living with inflammatory bowel disease by changing the treatment paradigm and initiate treatment with the biologic therapy (rather than conventional treatment involving enteral nutrition and corticosteroid therapy). The use of first line infliximab therapy led of significant clinical and endoscopic remission for the children involved (ie, improved health outcomes, disease management and quality of life).

Biosimilar manufacturers have published numerous studies demonstrating clinical equivalence, yet there are far fewer publications from health systems showing real-world benefits—such as increased or earlier patient access and how savings are being reinvested into care. How can we encourage more transparency and data sharing from health systems?

 Regulators have the possibility to publish reviews of pharmacovigilance data on a regular basis. While the absence of ‘unexpected issues’ maybe unattractive for publishers, it has the merit of reinforcing the robustness of the regulatory system, its standards and the compliance to them. In Europe, there have been 2 such reviews supporting the confidence of healthcare professionals and patients.

2013: Traceability of biopharmaceuticals in spontaneous reporting systems: a cross-sectional study in the FDA Adverse Event Reporting System (FAERS) and EudraVigilance databases. Drug Saf. 2013 Aug;36(8):617-25. doi: 10.1007/s40264-013-0073-3.

2015: Traceability of biologicals: present challenges in pharmacovigilance Expert Opin Drug Saf. 2015 Jan;14(1):63-72. doi: 10.1517/14740338.2015.972362. Epub 2014 Nov 5.

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