Ryan Haumschild, PharmD, MS, MBA, director of pharmacy services at Emory Healthcare and Winship Cancer Institute, explains how oncology practices can work better with payers to increase biosimilar adoption and how those collaborations can be applied to other disease areas, such as immunology and neurology.
Ryan Haumschild, PharmD, MS, MBA, director of pharmacy services at Emory Healthcare and Winship Cancer Institute, commented on how oncology practices can leverage their experience with oncology biosimilars and work with payers to increase biosimilar accessibility and improve adoption rates.
Although oncology biosimilars have experienced pretty good adoption rates overall, a recent study found that biosimilars for cancer are significantly more likely to have coverage restrictions than their reference products. How can oncology practices work better with payers to ensure adequate coverage for biosimilars and better market competition?
I did see that study. And I think you're right. We would have thought as biosimilar utilization continues to grow [that] some of our managed care and payer policies would also reflect that. But I think you're also overcoming historical agreements in terms of rebating and some of the contracting but also some of the real-world evidence that might be in favor of the reference products.
But what we need to do, and continue to do, is engage our key opinion leaders. And when we're meeting with payers and providers, we're explaining the data—at least creating parity access between biosimilar reference product. So if we are looking to reduce costs for a plan or reduce total health care utilization, that's really going to be a positive thing. And when we came out of the Oncology Care Model, we saw one of the drivers and the key success of that model was the adoption of biosimilars.
So now, how do we leverage that for the provider group and the payer group, ensure at least parity or prioritization, and start to have more of those transparent conversations as we move forward? I think it's gonna be a really good thing but I also recognize those dynamics from our managed care partners that we also have to navigate from a cost perspective and rebate perspective.
How can this collaboration be translated to other health care fields, such as multiple sclerosis and ophthalmology?
I think it is relatable. And I think what we've done in oncology is great, but I think we can bring that into more of the inflammatory disease states, with adalimumab, and I think we can bring it into multiple sclerosis and brain health, with those biosimilars and that disruption that's about to occur there. And I think having more options and having a less costly option that still provides that same therapeutic benefit, I think is a good thing.