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Rolf Benirschke: Access to Biologics for IBD
Rolf Benirschke, chief executive officer of Legacy Health Strategies, discusses the challenges patients face in getting access to biologics to treat inflammatory bowel disease.
Transcript:
Patients face a lot of challenges when it comes to getting on therapy, particularly some of the biologics. What we're finding is that, physicians, particularly the sophisticated physicians, a lot of the academic institutions, are able to subjectively figure out which patients will respond to which biologic, but if they go to prescribe that biologic, oftentimes, the insurers will not allow the patient to get on it until they fail another therapy.
So it’s this fail-first therapy before they get access to it. That's frustrating for the patient, and frustrating for the physician. If the physician is pretty good at determining that this patient likely will not do well, in his mind, why does that patient have to fail first?
Also, it’s tough for the patient. They go through a regimen that doesn't work, their disease progresses, gets more entrenched, and then it’s a more difficult disease to face. So that’s one of the big challenges currently.
PBM Evolution Toward Value-Based Care Shifts to Transparent Pharmacy Pricing
March 30th 2025Josh Canavan, PharmD, RazorMetrics, and Chris O'Dell, Turquoise Health, predict pharmacy benefit managers (PBMs) will evolve toward value-based care, mirroring the broader shift toward open-cost structures.
How AI Can Help Address Cost-Related Nonadherence to Biologic, Biosimilar Treatment
March 9th 2025Despite saving billions, biosimilars still account for only a small share of the biologics market—what's standing in the way of broader adoption and how can artificial intelligence (AI) help change that?
Empowering Vulnerable Populations: The Path to Equitable Biologic Therapy Access
December 22nd 2024Elie Bahou, PharmD, senior vice president and system chief pharmacy officer at Providence, discusses strategies to improve equitable access to biologic therapies, including tiered formularies, income-based cost sharing, patient assistance programs, and fostering payer partnerships.
Biosimilars in America: Overcoming Barriers and Maximizing Impact
July 21st 2024Join us as we explore the complexities of the US biosimilars market, discussing legislative influences, payer and provider adoption factors, and strategies to overcome industry challenges with expert insights from Kyle Noonan, PharmD, MS, value & access strategy manager at Cencora.
Can Global Policies to Boost Biosimilar Adoption Work in the US?
November 17th 2024On this special episode of Not So Different honoring Global Biosimilars Week, Craig Burton, executive director of the Biosimilars Council, explores how global policies—from incentives to health equity strategies—could boost biosimilar adoption in the US.
Q&A With Dr Chelsee Jensen: Navigating FDA Approvals, Challenges in the Biosimilar Landscape
January 14th 2024Chelsee Jensen, PharmD, BCPS, senior pharmacy specialist and pharmaceutical formulary manager at Mayo Clinic, reacts to the biggest FDA approvals of 2023 and how she sees the adalimumab, natalizumab, and tocilizumab spaces playing out.
