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Increasing Access and Decreasing Costs With Biosimilars

June 2018

During the NAMCP Spring Managed Care Forum 2018, Robert M Rifkin, MD, FACP, medical director of biosimilars at McKesson Specialty Health, The US Oncology Network, explained how biosimilars can add value by increasing access and decreasing costs.

Dr Rifkin started his presentation by explaining that biosimilars could reduce direct health care spending by $54 billion over the next 10 years. He also cited data from Express Scripts that showed a potential for $250 billion in overall savings with the introduction of 11 biosimilars to the market. 

According to comparative pricing data presented by Dr Rifkin, biologics represent a significant cost burden to patients, at 22 times more expensive than small molecules. He explained that increases in cancer drug prices have significantly decreased patient affordability. He showed that the median monthly cost for cancer drugs has increased to $10,000 over the last 40 years while the median monthly household income has remained at $4000.

Dr Rifkin explained that biosimilars could mitigate this burden by giving patients more options and increasing competition on the market.

“As more biosimilars are introduced into the market, patients will have greater treatment options, greater access to these options, and perhaps due to market dynamics, greater degree of affordability,” he said.

He explained that in order to capture this value, biosimilar manufacturers will have to overcome a number of barriers with physicians, including clinical concerns, ease of use concerns, and economic concerns.

However, Dr Rifkin also noted that payer education is equally as important as physician education. He said that payers must move away from formulary exclusions in order to increase adoption of biosimilars and decrease the overall cost burden.

David Costill