Christine Baeder Discusses Generic Awareness and Challenges that Lie in Biosimilar in Generic Spaces

Christine Baeder, the new chair of the AAM and chief operating officer for US generics and biosimilars at Teva Pharmaceuticals USA, talks about what’s first on the list in her new role, as well as the challenges that she expects to encounter and her plan of action.

Transcript

What are the main goals and initiatives that you want to prioritize in your new role as AAM chair?

Certainly, my most important role is raising awareness of the generic industry, and the fact that, I think, we're approaching a crisis of sustainability. We're already starting to see some manufacturers leave the market for financial reasons, as well as less investment in new products. I think it's time that we all come together and speak with one voice and make sure that we remember that generics are a US success story. The legislators, the regulators, and the third-party industry works together and created this amazing thing, which is generic pharmaceuticals, which is something now that we all count on as the backbone of our health care system. Over 90% of prescriptions, less than 20% of the cost, by every definition, that's a success story, and it touches every family in the country. I don't think there's anybody who hasn't taken a generic drug at some point in time. So, it's important that we continue to foster and support that industry going forward.

What challenges in the biosimilar and generic spaces are you looking to tackle first and how do you plan to address them?

The first one is to try to talk about anything that doesn't support the additional sustainability of generics and the biosimilar space. We'll talk about them separately; they have somewhat different issues. The generic industry has been working for a very long time, and over time, what's happened is there has been the erosion of the incentives that make the system work really well. When I started in generics, when a generic product was launched, you would get to 80% utilization of generics within a very short period of time, let's call it 6 months. What we've seen is that innovative companies have been very successful as of late in having strategies that maintain their market share for a longer period of time, and those are things that just don't make sense to me. So that's one of the things that we would be tackling. We would support a legislative solution that says, if it's a generic medication, it’s offered on a generic tier for patients.

I think one of the challenges in discussing the generic industry is that people's perception is that the price of medication is too high. Generic medications are not expensive. The average copay for a generic medication is $6. So, there's something going on in the system that doesn't allow people to feel the benefit and the value that generic products bring. So, I would be fully supportive of a review of the value chain. I support pharmacists getting compensated for the work that they do; speaking to a patient, that can take a lot of time, people have a lot of questions and pharmacists are very trusted. And they're accessible. You can go into your pharmacy and talk to someone; you can’t always just drop by your doctor's office. So, I fully support that. And I recognize the value that the wholesalers bring in moving product from place to place, especially cold chain products, that's not easy to ensure that it's delivered within the temperature conditions that's required to make the medication work as it's supposed to.

So, I'm not against other people in the value chain getting recognized for the value that they bring. But we do need to ensure that the savings that we create by bringing multiple generics to the market also impact the patient at the pharmacy counter, and that people are feeling the erosion of the price that's associated with market competition. Sometimes that doesn't happen, and why is a super complicated question. For sure, that's something that I would support looking into and trying to figure out how we can do better.

Biosimilars are a bit different, right? We don't have the built-in incentives that we have on the generic space. If you go back 20 or 30 years, I know I got trained on what's a generic when I went to the pharmacy counter, and they're like, “well, you can get this drug for $5. Or you can get the same drug in a different box and it's $40,” which creates just an inherent incentive at the patient level. And then that patient helps create that incentive at the health care practitioner level. They're like, “hey, I want the cheaper one, can I get the cheaper one?” We don't have that yet for biosimilars.

Biosimilars are actually approved as brands. So, all of the mechanisms at the state level and different legislation over the years that creates that national incentive for generics to be a more affordable option, don't exist in the same way yet for biosimilars. I would certainly encourage that we continue to look at, what do we need to do to create an incentive down to the patient level for biosimilar utilization? In addition, if you go up one more step to health care practitioners, there's really not an incentive there either because the patient isn't saying, “hey, that's cheaper,” the patient’s saying “well, I can get this the same one I've always got at the same price. So why wouldn't I just do that?” And the doctor has to do nothing to do what he or she has always done, as opposed to learn the names of 10 other new drugs and remember which one is which one he wants to give, which is a heavier lift than just doing nothing. So, we need to create incentives at every piece of the value chain to help biosimilars be successful.