Bruce A. Feinberg, DO: Hope, where do you think this all shakes out in 5 years? Are biosimilars really well entrenched in our armamentarium of therapeutics? People are using them as they use generics today, to Marcus’s point. Is there a biosimilar for this? Does that happen? Where do you think we are?
Hope S. Rugo, MD: I think that we’re going to see an incorporation of biosimilars into the market. I think that originator product manufacturers, producers, are going to try different ways of making their product different—either by packaging or giving it a different way. That will allow them to have the main part of the market share, such as we’ve seen with pegfilgrastim, which is something that really benefits patients, I will say, for several different reasons. And the alternative drugs, of course, will be out there. They are not yet ready to be off patent and be biosimilars, however.
I think biosimilars are going to be part of our daily life in prescribing. We’re going to be able to use biosimilars. I think, in the United States, we are not going to be able to choose which one we give. We’re going to be able to comment on it. And if somebody has a reaction to one and not the other, which we haven’t seen yet in any of the trials, we would be able to make a case—a peer-to-peer, etc—like we do now. But otherwise, I think they’re just going to be incorporated into our practices, and we’re not going to have a big choice as to which one is going to be incorporated into our particular practice or into, for example, a purchasing group in the group practices that are out there.
In the rest of the world, we’ve already seen the incorporation of biosimilars in the European market, and they seem to be well tolerated. I haven’t heard of any significant concerns there. They’ve been way ahead of us in the biosimilar area because they have had shorter patent lives and, also, because of the cost structure with the way things are covered. Biosimilar therapeutic agents are already being incorporated into treatment planning in other parts of the world. I was talking to a colleague from the United Arab Emirates, where biosimilars are coming and will be used in the very near future once they’re approved because of cost savings for the governments in that situation. So, I think that we will join in in this general area despite our different payment structures, and biosimilars will become part of what we use.
Bruce A. Feinberg, DO: Dr. Rugo, Dr. Snow, and Dr. Shank, it has been my pleasure to get to work with you today on the panel. Thank you all for your contributions to this discussion. On behalf of our panel, we thank you for joining us and we hope you found this Peer Exchange• discussion to be useful and informative.