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Louis Tharp and Stephen Marmaras: Biosimilars and the Healthcare System


Louis Tharp, cofounder and executive director of the Global Healthy Living Foundation, and Stephen Marmaras, director of policy and advocacy for the Global Healthy Living Foundation, discuss the value of biosimilars to the healthcare system.


What role can biosimilars play in bringing down costs for patients and for the healthcare system?

LT: I think biosimilars are a natural outgrowth of, of course, the biologic—the innovator biologics—and they are the solution to the near-term cost issue and the near-term access issue. It doesn’t mean that biologics may not come down in price to meet biosimilar pricing, and good for that, we would love that. We’ve seen that when drugs have gone from branded to generic, we see the brand name drugs become lower.

The most important part of biosimilars today is the fact that they’re going to be able to bring greater access to patients. How do we think this is going to happen and who do we think is going to benefit from it?

We think that, in the first place, the biologically naïve patients should have the first access to biosimilars based on cost. If biologics are as cheap, good for them. But we really need to look at how soon we’re getting folks onto these medicines.

We’re also looking at, if you’re already on a monotherapy like a methotrexate, how long are you going to stay on methotrexate? Oftentimes, the insurance companies, whether it’s the medical benefits folks with infusion drugs or [pharmacy benefit managers, PBMs] with injectables, will have an arbitrary date that says “you’ll be on methotrexate for 6 months and then we’ll see how you’re doing.”

Well, it seems to us that there’s a simpler answer to this than just an arbitrary date, and that’s just radiography. You can have X-rays and you can see, in this case, ‘Is my rheumatoid arthritis progressing?’ If it’s progressing under methotrexate, it’s time to get onto a biologic. If biosimilars are cheaper, if biosimilars are more available, then it’s time to get them on a biosimilar.

We think that this is going to compress the time between diagnosis and what most professionals would consider appropriate therapy.

SM: Yeah, I would add just the point that education is really going to be key here in order for biosimilar uptake to be a positive one. In order for the promise of biosimilars to be achieved, and those prices start to go down, and patients start to realize those benefits, we really need to have confidence. Patients need to have confidence, physicians need to have confidence, and the only way we’re going to get to confidence is through education.

Education is a little bit more difficult than it may sound because it’s very difficult to get all of these stakeholders to agree on similar educational approaches. I think we look to [the] FDA to take the lead here, and we’re really pleased that they have. They’ve released some very valuable tools on their website, and [I] would encourage folks to check those out, but there really isn’t a ‘1-stop-shop’ for education right now. Just like everything else, it’s important that you go to trusted sources. Go to patient advocacy organizations like ours or others in the arthritis area, [or] in the oncology area. Many of us have educational materials and many of them are robust.

I will mention that there are efforts underway through collections of organizations like the Biosimilars Forum where some of these very diverse stakeholders are getting together, having difficult conversations, and coming out with educational principles that we’ll all be promoting collectively.

I think that will be a massive step forward, but in order for us to achieve that critical cost savings, we’re going to have to educate together. So, the [Global Healthy Living Foundation, GHLF] and others are committed. The great news is that we’re all committed to working together to make sure that educational effort is uniform.

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