Bruce Feinberg, DO: Michael, I hear those numbers, and I think, “Will this be fleeting?” Trastuzumab has 3 very provocative competitors. One or 2 are already approved, and a third likely will be, and that will dramatically change that space. I think bevacizumab is being called into question more and more. You finally have data suggesting Gazyva may be a better CD20 monoclonal antibody.
Even if there is an adoption, if it’s evidence based and you have the next-generation version that’s better, will it be fleeting or do you think it’s longer lasting?
Michael Diaz, MD: That’s not an easy question to answer. Why? We might find that 1 of these newer-generation reference drugs works better in some situations, or maybe it doesn’t. That’s where we’re going to have to rely on the detailed information and hopefully well-developed clinical trials. If we do see that we need to use 1 of the newer-generation reference products because there is not a biosimilar available for it yet, then we’ll know that we’re using it based on evidence, and hopefully we’ll be able to identify those who can benefit from that. Hopefully, it’s not necessarily the whole patient population. There has to be some social responsibility to try to make sure that those patients are identified so that we can more carefully tailor which patients could possibly be treated equivalently with a biosimilar and which patients might require a newer-generation medication.
I don’t think the biosimilars are going to be a fleeting thing. They’re going to be here for a while because of the large amount of evidence that does exist. I’m just hopeful that our researchers will be very thoughtful in their designs in the future.
Bruce Feinberg, DO: Great. Thank you.