Catherine Swick, MBA, senior vice president of Provider Strategy and Marketing at McKesson, discusses efforts to get oncology biosimilars into play at US Oncology Network.
Catherine Swick, MBA, senior vice president of Provider Strategy and Marketing at McKesson, recalls that oncology biosimilars have long been a part of the discussion, and once they became available, McKesson began working hard to promote their use.
“I would say that biosimilars, especially initially, were hard to accept, because people trusted that [original brand] drug they had been using for so many years, but once people got comfortable with the concept of [biosimilar] clinical similarity and what that really meant in terms of effective, safe patient care, we saw that transition happen quickly,” Swick said in an interview with The Center for Biosimilars®.
McKesson provides back office, human relations, technology, and billing assistance, among other services, for the US Oncology Network, which encompasses 1400 physicians in roughly 60 oncology practices across 30 states.
“The US Oncology Network has put a massive amount of effort into switching to biosimilars over the last 18 months, and you can really see that in their results. We typically see 80% to 90% biosimilar adoption across the US Oncology Network,” Swick said.
Biosimilars have helped practices manage COVID-19-related financial pressure and continue to serve vulnerable populations, and the Oncology Care Model, the CMS value-based experiment in departure from the buy-and-bill style of health care practice, has made it even more important to use biosimilars, Swick said. “If you really want to succeed in the Oncology Care Model or any of your commercial value-based care contracts, switching to biosimilars is the right thing to do there,” she said.
At McKesson, education has been the main tool to get providers on board with prescribing biosimilars. “We’ve been beating the drum about clinical similarity and the fact that these biosimilars were coming for years now, so that helped pave the road toward them. Beyond that, [it has involved] a lot of education—practice by practice—and work with physicians, pharmacists, and nurses to help them understand the benefit of biosimilars, and also the safety and efficacy associated with them.”
Payers can play an important role in biosimilar adoption, although their prescription mandates, based on contracts with biologics supply companies, may interfere, according to Swick. These strip providers of their ability to choose therapeutic agents. Mandates based on pharmaceutical rebates may also foster inefficiency within practices, which may be forced to carry multiple preferred biosimilars or other biologics, leading to high inventory costs, waste, and the potential for error. Swick said she would like to see payers develop value-based care reimbursement models that align physician and payer incentives and encourage biosimilar adoption.
She expressed concern about the potential consequences of white bagging, under which drugs are delivered to practices by specialty pharmacies, adding an extra layer of management and complexity to the time-sensitive oncology treatment process. This trend has not yet emerged in the oncology sector, but it bears watching, she said.
“White bagging is a constant threat, I would say, to community oncology as a whole,” she said. “What white bagging does is it cuts out physician choice. It also separates what we have today, which is an incredibly efficient supply chain of the drug getting from the biopharma company to the practice in a timely, safe, fashion,” Swick said.