JMCP Publishes CPS's Biosimilars Research

The Journal of Managed Care & Pharmacy (JMCP) publishes findings from CPS's study, "Biosimilar perceptions among autoimmune prescribers and pharmacists in health system specialty pharmacy."

March 2024

Officials expect biosimilars to reduce direct spending on biologics by an estimated $54 billion by the end of 2026.*

However, the therapies are new, and providers and prescribers may have knowledge gaps or biases that could impact adoption. Health system specialty pharmacy (HSSP) teams can address these barriers. But research about how and where they can best help has been limited.

That’s why our health system specialty pharmacy clinical outcomes research team set out to study prescribers’ and providers’ attitudes and prescribing habits surrounding biosimilars. Their study, “Biosimilar perceptions among autoimmune prescribers and pharmacists in health system specialty pharmacy,” was recently published by the Journal of Managed Care + Specialty Pharmacy (JMCP).

Below, we review the top learnings and takeaways with the authors, including: Carly Giavatto, PharmD; Jessica Mourani, PharmD; Casey Fitzpatrick, PharmD, BCPS; Brandon Hardin, PharmD, MBA, CSP; Amber Skrtic, PharmD, CSP, AAHIVP; Amy Evans, PharmD, CSP; Eric Sredzinski, PharmD; Susan Trieu, PharmD; Adam I. Setter, PharmD; Larry Kobiska, PharmD; and Ana I. Lopez-Medina, PharmD.
 

CPS: Congratulations! Can you tell us more about the study? What were we hoping to learn?

AUTHORS: Thank you! We are grateful for the opportunity to tell more people about this important work, as biosimilars could help reduce healthcare costs.

Our study examined knowledge and perceptions of biosimilar products in the autoimmune space. Multiple Humira biosimilars are now on the market, so we wanted to evaluate autoimmune disease specialist providers and prescribers attitudes and habits. Recent surveys suggest rheumatologists may feel uncomfortable recommending biosimilars to patients today. That's why we wanted to understand:

1. What do autoimmune providers and prescribers know and perceive about biosimilars?
2. How comfortable are HSSPs in making biosimilar substitutions? 
3. How can HSSPs close knowledge gaps and help to address biosimilar uptake in the autoimmune space?
   

Our insights will help providers and pharmacists better foresee issues that may occur when patients switch to a biosimilar product. Understanding the barriers will enable us to provide better support when and where they are most needed.

CPS: What were the study's key findings?

AUTHORS: We found many providers and pharmacists seem hesitant to prescribe biosimilars, and many report feeling unprepared to counsel patients about their options.

Here are the findings that stood out:

1. Less than 20 percent of providers and pharmacists feel "very prepared" to discuss biosimilar options with patients.
2. Less than half of prescribers and pharmacists understood regulations of interchangeability and biosimilar substitution.
3. Less than 20 percent of providers and pharmacists would recommend a biosimilar to patients who are already successfully established on biologic therapy.

Finding that only some individuals felt fully prepared to have conversations with patients about biosimilar options or understood interchangeability highlights a need for market readiness so pharmacists and providers can continue to ensure safe and effective treatment approaches to promote the best care for patients. 

CPS: Why is it timely to study provider and pharmacist perceptions regarding biosimilars?

AUTHORS: The launch of adalimumab biosimilars is monumental for specialty pharmacies. It will be the first time many specialty pharmacists and care teams have had to navigate biosimilars. Previously, they were primarily seen only in the infusion space and among diabetic patients on insulin.

As we gear up for the newly approved biosimilars to hit the market, we need to see where the uptake barriers exist so we can address any knowledge or adherence gaps related to these new therapies.

CPS: What do the findings reveal about how providers and pharmacists will adopt biosimilars in the autoimmune space? 

AUTHORS:  Our study highlights several knowledge gaps and hesitancies among providers and pharmacists associated with biosimilar adoption. Even though pharmacists serve as a “safety net” for prescribers, we learned that prescribers perform initial assessments, make diagnoses, and prescribe treatments. Therefore, provider hesitancies may cause a lack of biosimilar uptake.

Providers and pharmacists will also need to navigate the payor mandates, operational burdens, and educational gaps, as well as ensure their patients understand the change and can afford it.  

As new biosimilar therapies are emerging, HSSPs may need to provide more continuing education for providers. As prescribers and pharmacists gain more experience with these new therapies, we anticipate they’ll become more comfortable prescribing biosimilar therapies to their patients.

CPS: What can HSSP teams learn and apply from the study?

AUTHORS: The study reinforces that HSSPs are uniquely positioned to help drive biosimilar awareness and uptake. HSSPs are well-equipped to drive greater uptake of biosimilars by:

• Handling questions and concerns about the therapies and their reference product comparisons.
• Ensuring people can access therapies by overcoming barriers like financial assistance.

Therefore, HSSP pharmacists should actively participate in educational programs and opportunities that enhance their biosimilar knowledge. This will increase their confidence in counseling prescribers and patients and navigating conversion conversations.

CPS: What should be studied next around biosimilar adoption?

Future studies should evaluate how improving knowledge gaps can impact biosimilar perception and adoption.

Once prescribers are more comfortable with biosimilars, we will likely need to study how biosimilar conversions affect adherence and persistence.

It would also be beneficial to understand how patients perceive these therapies.

Finally, it would be interesting to understand how biosimilar uptake impacts the healthcare system. Biosimilar uptake may provide an equally efficacious medication while being good stewards of healthcare savings. 

If people want to learn more, this study is an excellent place to start. Click the link to read the full manuscript.

* Source: Mulcahy AW, Hlavka JP, Case SR. Biosimilar cost savings in the United States. Initial experience and future potential. Accessed February 2, 2023. https://www.rand.org/pubs/perspectives/PE264.html