Kaiser Permanente got biosimilars into circulation by building physician confidence, a strategy that a Samsung Bioepis executive says should be employed more widely.
Biosimilars can reduce the costs of cancer care in the United States, which according to one estimate are expected to reach $246 billion by 2030, up 34% from $183 billion in 2015. But providers’ confidence in these lower-cost agents needs stronger support, Albert Kim, vice president of the Commercial Division at Samsung Bioepis, explained in a recent blog.
“It is important that prescribers understand how biosimilars work and why they are safe to use and are able to tell what value biosimilars bring from the patient’s perspective,” he wrote.
Samsung Bioepis has developed multiple biosimilars that are now approved and marketed, including Byooviz (SB11), a ranibizumab biosimilar referencing Lucentis that was approved by the European Commission in August 2021. Byooviz is the first biosimilar for ranibizumab, used in the treatment of macular degeneration and other ophthalmic diseases.
“Biosimilars are a practical solution to the current health care system in terms of providing physicians and patients more ‘choice’ of medicines that have the comparable quality, efficacy, and safety as the reference medicine, potentially saving millions of dollars for health care systems and practices,” Kim wrote.
He is a strong advocate of the policies adopted by Kaiser Permanente, whose payer-provider integrated network has enabled it to promote the use of biosimilars and disseminate reliable information about these agents.
For example, following its approval in 2016, the biosimilar Inflectra (infliximab) had achieved just a 3.2% market share in the United States by 2019. Kaiser Permanente, however, achieved far greater success in getting physicians to use this product. Their usage rate by 2019 was 80%.
Kaiser Permanente attributes this success to multiple reasons:
Kim agrees. “As more hospital networks are looking to transition toward value-based care model, it would be beneficial to have more practices share their success stories with biosimilar implementation and the practical solutions to overcoming operational challenges so that other institutions feel more at ease when they start considering biosimilar implementation, including clinical assessment, electronic medical records integration, economic assessment, and most importantly, ensuring provider utilization and comfort and patient education,” he wrote.
Kaiser Permanente was quick to adopt some biosimilars and slower with others. The payer endorsed the use of Zarxio, a filgrastim biosimilar to Neupogen, roughly 9 months after Zarxio was approved by the FDA. It waited a year before adopting Inflectra, following that biosimilar’s approval in April 2016. And it was close to 2 years after the approval of Mvasi, a bevacizumab biosimilar referencing Avastin, that Kaiser Permanente adopted use of this product. Similarly, Kaiser Permanente adopted Truxima, a rituximab biosimilar, a year after its approval in November 2018.
Kaiser Permanente contends that improvement is needed in incentives for biosimilar adoption and uptake.
“Converting patients from reference products and overcoming other operational barriers to using biosimilars can be resource intensive. Policy makers may need to provide temporary support to encourage providers to take these steps until a greater level of expertise with biosimilars is achieved,” the company said in a presentation on these agents.
Payment issues also need resolution, the company states. “Potentially insufficient or perverse payment incentives that encourage providers and health plans to prefer more expensive reference biologics over biosimilars should be examined and addressed.”
The Center for Biosimilars® covered the Byooviz marketing authorization by the European Commission. Ocular diseases and biosimilars have been a contentious issue lately between payers and eye disease specialists. Ranibizumab was specifically approved for these indications, but the use of bevacizumab biosimilars in these settings is not as well clarified by regulatory actions.