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Conference Coverage

Biosimilar Conversion Hesitancy Addressed by New Data

Edan Stanley

The benefits of biosimilars are already proven as they are clinically equivalent to brand therapies and cost significantly less. However, physician understanding and confidence in biosimilar products is seen as a major conversion barrier and prevents financial savings for patients, practices, and payers.

According to a poster presentation at the 2021 ASCO Quality Care Symposium, “rapid and near-complete conversion from brand product to FDA approved biosimilar is feasible, measurable and can be scaled.”

David Waterhouse, MD, and colleagues explained the financial savings loss ranges between 21% and 24% based on October 2020 data from the Centers for Medicare & Medicaid Services. “The effective conversion to biosimilar products is vitally important to total cost-of-care savings and can be achieved without negatively affecting patient outcomes,” Dr Waterhouse and colleagues explained.

Their research examined the concept of interchangeability, the FDA designation that allows generic substitutions at the pharmacy without physician consent, and how the same concept could be built upon other auto-substitution processes with therapeutic exchange.

“…a formalized biosimilar policy and SOP was developed to automate conversion from the reference biologic product to the P&T/Physician approved biosimilar,” said the researchers. “Workflow changes were instituted to alleviate the provider burden of patient-by-patient decisions and placed them with the pharmacy review team.”

Physicians, advanced practice providers, pharmacists, nurses, financial navigators, and prior authorization team members supported and endorsed biosimilar usage through mandatory biosimilar education. Patient education was also established and tracked via the electronic health record.

Between July 1, 2019 and December 31, 2020, Dr Waterhouse and colleagues used quantitative metrics and reports to track the number of unique patients receiving the brand or biosimilar agents for rituximab, trastuzumab, and bevacizumab.

During the observation period, biosimilar conversion ranged 0% to 8.4%, for trastuzumab and rituximab, respectively.

“Following full staff education and physician consent, systematic auto-conversion to biosimilar products was initiated on January 1, 2020,” explained the researchers. “Conversion rates based upon billed biosimilar units likewise improved from 11.7% (baseline) to 90.2% (2021 Q1) for rituximab, 8.4% to 87.4% for trastuzumab, and 0% to 90.0% for bevacizumab.”

Per the data, the researchers concluded that rapid and near-complete FDA-approved biosimilar conversion from brand products is feasible, measurable, and can be scaled.

Reference:
Waterhouse DM, Burdette C, Davies C, Drosick DR, Mendenhall M. Scaled integration of FDA approved biosimilars: Closing the knowledge and adoption gaps. J Clin Oncol. 2021;39(suppl 28; abstr 15). doi:10.1200/JCO.2020.39.28_suppl.015