Education Is the Biggest Factor in Promoting Biosimilar Use, Says Dr Prerakkumar Parikh

Prerakkumar Parikh, PharmD, director of specialty clinical solutions at Magellan Rx Management, explains the roles of formulary placement and tiering by pharmacy benefit managers (PBMs) in relation to biosimilars and how they affect the cost-sharing burden for patients who choose them. He also discusses how stakeholders, like health care providers and policymakers, can work with PBMs to promote the use of biosimilars.

Parikh went into more detail on biosimilars during the AMCP Nexus session, "Biosimilar Operational Readiness: Managed Care Stakeholder Response to Market Expansion Impact.

Transcript

Can you explain the roles of formulary placement and tiering by PBMs? How do these decisions affect the cost-sharing burden for patients who choose biosimilars over reference biologics?

The tiering, some of the biosimilars that have came out are in the specialty tier. So far on the pharmacy benefit side, we are seeing the adalimumab biosimilars on that specialty tier along with the brand name product, Humira.

So, what that will do is it will allow for access. At the same time, if you have a low-WAC [wholesale acquisition cost] biosimilar at the same level as Humira, and if a patient is paying a percentage coinsurance on that specialty tier, a low-WAC biosimilar is going to reduce that cost for the patient, as well.

How can stakeholders, including policymakers, manufacturers, and health care providers, work with PBMs to promote biosimilars and encourage adoption?

The biggest factor into promoting biosimilar use and encouraging the use will be to educate patients and educate providers. I think we as an industry, all the stakeholders, need to make sure that we have resources that help the providers and the patients understand the value of biosimilars, the cost savings from biosimilars, and, at the same time, how biosimilars have the same clinical efficacy and safety as the reference product.