Biosimilars

Marketplace Responses

Biologics are extremely expensive and have increased in cost since they first came to market. [5] Because of the cost, many patients use copay assistance to afford their treatment. Competition from biosimilars is theoretically thought to be able to help lower costs of treatment and free up resources within the health care system to improve access. [6] However, Dr. Feldman feels that the changes brought about by biosimilars may be hard to predict. “I don’t think this is going to help psoriasis patients a lot, because the reduction in cost is not likely to be large enough to improve drug access,” Feldman says.

While there are a variety of biologics that have biosimilars in the pipeline, there are also many biologics that do not have biosimilars currently under investigation. Policy changes may limit access to other non-biosimilar treatments. For instance, Feldman mentions that insurers may change reimbursement guidelines to encourage use of lower-cost biosimilars over innovator drugs that do not yet have biosimilars. “Because biosimilars function so similar to the innovator product, we won’t be able to help psoriasis patients with biosimilars unless we could help them already with the innovator,” Feldman says.

Overall, Dr. Feldman foresees a decrease in prices of biologics that face biosimilar competition by around 30% in the first few years. However, changes in price do not equal changes in access, and Dr. Feldman feels that changes to access will be hard to predict. “Overall, I don’t think there’s going to be much change in access at all,” Dr. Feldman says. In the European Union, biosimilar access was limited by responses by the innovator companies, relatively small price savings, and reluctance of physicians to use biosimilars. [6]

Patient Responses

As more biosimilars are approved in the U.S. and patients learn about biosimilars through media coverage and advertisements, Dr. Feldman thinks that some patients may have hesitations regarding taking biosimilars. “I know physicians who were very hesitant with the idea of biosimilars, too,” Dr. Feldman says, as biologic manufacturing is complicated and physicians may think that biosimilars may not perform the same as the innovator biologic.

“However, once patients and doctors realize that no one can duplicate a biologic, not even the innovator company, I think they will be more accepting of biosimilars that are basically – for all practical purposes – just like another batch of the innovator,” Dr. Feldman says.

He adds that he thinks patients will have to be counseled on an individual basis. Some may benefit from an explanation about what biosimilars are and whether they are effective; others may need more specific information explaining the manufacturing process and the similarities and differences between biosimilars and their innovator biologics.

Despite challenges and unknowns, the future shows promise for more biosimilars. Biosimilars of infliximab in the U.S. already exist, while ustekinumab biosimilars are currently under investigation. And despite the unpredictable responses of the marketplace, many are optimistic about biosimilars and how they will affect patient care. [7]