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WHEN CHOICE ARRIVES: Competition & Consequences

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BIOSIMILAR APPROVALS

Articles

Biocon Biologics expands its oncology biosimilar roster after gaining FDA approval for Jobevne (bevacizumab-nwgd), the sixth biosimilar referencing Avastin (bevacizumab).

FDA Approves Biocon Biologics' Bevacizumab Biosimilar

Teva and Samsung Bioepis have launched Epysqli, a cost-saving Soliris biosimilar, offering a 30% discount and new hope for patients with rare, life-threatening hematologic conditions.

Teva and Samsung Bioepis Launch Biosimilar Epysqli 

Sarfaraz K. Niazi, PhD, is an adjunct professor of biopharmaceutical sciences at the University of Illinois and the University of Houston, and founder of biosimilars companies Karyo Biologics and Adello Biologics. He also founded the biosimilar advisory company PharmSci.

Affirming that analytical characterization is often sufficient for biosimilar approval, minimizing unnecessary clinical testing, and enhancing FDA-led education to counter stakeholder misconceptions are key recommendations put forth in this opinion piece by Sarfaraz K. Niazi, PhD.

BioRationality: Commemorating the 15th Anniversary of the BPCIA

Early market entry, manufacturing efficiency, and market share are critical to biosimilar development success, while technical complexity and competition heavily impact returns, according to a study presenting a risk-adjusted net present value (NPV) analysis framework.

Risk-Adjusted NPV Framework for Biosimilars Shows Key Investment Drivers

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1rem

Business & Practice

 focuses on the critical issue of cost-related nonadherence in biologic treatments and the role of biosimilars in delivering promised savings. Despite the FDA approving 68 biosimilars, they currently make up only 2% to 3% of the U.S. biologics market, with market share varying significantly between individual markets, ranging from 8% to 82%.

Biosimilars have, however, demonstrated significant cost savings over the past decade. According to data from the Association for Accessible Medicines (AAM), generics and biosimilars collectively saved the U.S. a total of $445 billion by the end of 2023. Biosimilars alone accounted for $12.4 billion in savings in 2023, bringing total savings to $36 billion since their introduction in 2015. Despite these savings, barriers remain, as many biologics set to lose patent exclusivity in the coming years lack biosimilars in development. Addressing cost-related nonadherence and leveraging artificial intelligence (AI) to streamline prescribing processes and increase biosimilar utilization are key topics of discussion.

Josh Canavan, head of pharmacy at RazorMetrics, provides insights into why, despite the substantial savings biosimilars offer, they still represent only 23% of the overall biologics market. The conversation explores how AI-powered tools are assisting physicians in transitioning to biosimilars, enabling patients to access life-saving treatments at a fraction of the cost. As the 10th anniversary of the first biosimilar approval is observed, the discussion highlights the importance of automation, policy reforms, and increased adoption to bridge the affordability gap and expand patient access to these critical treatments.

To learn more about the 10th anniversary of the first FDA biosimilar approval and current insights into the biosimilar industry, 

To learn more about how much biosimilars have saved so far, 

To read more about Josh's views on the pharmaceutical landscape in 2025, 

Despite saving billions, biosimilars still account for only a small share of the biologics market—what's standing in the way of broader adoption and how can artificial intelligence (AI) help change that?

How AI Can Help Address Cost-Related Nonadherence to Biologic, Biosimilar Treatment

This episode of Not So Different explores the possible implications of the Federal Trade Commission's (FTC) second interim report on pharmacy benefit managers (PBMs), which shed light on key issues with current PBM practices and their impact on drug prices. The report highlighted several troubling strategies, such as many cases where the big 3 PBMs were reimbursing their own affiliated pharmacies at higher rates than independent pharmacies. The report's latest findings raise important questions about the future of drug pricing transparency and regulation and challenge the notion of whether PBMs are delivering on their intended promise to benefit the health care system.

To help unpack these findings and their implications, The Center for Biosimilars

 was joined by Joe Wisniewski, an expert in PBM legislation, price transparency, and health care policy. Joe serves as assistant vice president of partnerships and government affairs at Turquoise Health and brings a wealth of insight into how PBMs are navigating the current landscape, especially with the rise of new biosimilars and shifting regulatory pressures.

This episode also explores how a second Trump administration could influence PBM practices, particularly in relation to biosimilars, and what that means for drug pricing efforts moving forward.

To learn more about the FTC's most recent report on PBMs, 

To learn more about the FTC's first report on PBMs, 

To learn more about health care actions taken by the second Trump Administration during it's first month, 

To learn more about the views of Mehmet Oz, MD (more commonly known as Dr. Oz) on price transparency ahead of his congressional confirmation hearings as President Trump's nominee for HHS Secretary, 

On this episode of Not So Different, we explore the Federal Trade Commission’s (FTC) second interim report on pharmacy benefit managers (PBMs) with Joe Wisniewski from Turquoise Health, discussing key issues like preferential reimbursement, drug pricing transparency, biosimilars, shifting regulations, and how a second Trump administration could reshape PBM practices.

Will the FTC Be More PBM-Friendly Under a Second Trump Administration?

On today's episode, we'll dive deep into the US biosimilars market landscape, a topic of growing importance as biosimilars offer significant potential for reducing health care costs and increasing access to life-saving therapies. Understanding the current legislative and regulatory environment is crucial, as it shapes the approval and adoption processes for biosimilars. We'll explore key factors affecting payer uptake and provider adoption of biosimilars in the US, such as economic considerations, clinical evidence, and market dynamics. These factors are vital for stakeholders aiming to effectively navigate the complex biosimilars landscape. Additionally, we'll examine the challenges and opportunities associated with biosimilars for stakeholders across the health care continuum, including manufacturers, payers, providers, and patients. Addressing these challenges and leveraging opportunities can enhance the impact of biosimilars on health care systems and patient outcomes, making this discussion essential for anyone involved in the health care industry.

Today, we're joined by Kyle Noonan, PharmD, MS, is a highly qualified expert who supports scientific and commercial consulting engagements at Cencora, helping manufacturers demonstrate the clinical and economic value of their products. His work includes outcomes research strategy, pre-approval information exchange, payer value proposition development, primary market research, pricing research, and market access strategy.

Dr. Noonan has a diverse background with experience in various health care settings, including medical affairs within the biopharmaceutical industry, association management, consulting, and clinical trial research. He has extensive leadership experience with the Academy of Managed Care Pharmacy (AMCP) and has presented numerous posters at AMCP conferences. Dr. Noonan holds a Doctor of Pharmacy from Mercer University and a Master's in Pharmaceutical Outcomes and Policy from the University of Florida.

To learn more about Cencora and their efforts, 

To learn more about the Inflation Reduction Act's impact on biosimilars, 

Join us as we explore the complexities of the US biosimilars market, discussing legislative influences, payer and provider adoption factors, and strategies to overcome industry challenges with expert insights from Kyle Noonan, PharmD, MS, value & access strategy manager at Cencora.








Biosimilars in America: Overcoming Barriers and Maximizing Impact

At Asembia 2023 in Las Vagas, Nevada, Tasmina Hydery, associate director of Digital Solutions at AmerisourceBergen, presented on the future of the biosimilars industry as well as how payers have responded to the influx of new biosimilar products in the United States. During the session, she shared results from AmerisourceBergen's report on the biosimilars pipeline, sharing survey results on how payers place biosimilars on formularies, their views on interchangeability, and their use of prior authorization and step therapy strategies to encourage providers to prescribe preferred products.

On today's episode, we spoke with Tasmina and her colleague, as well as a returning guest on the Not So Different podcast, Brian Biehn, senior director of Biosimilar Commercialization at AmerisourceBergen, about some of the points brought up during the presentation and some of the pricing trends that we're seeing in the space.

To learn more about Tasmina's Asembia 2023 presentation, 

AmerisourceBergen Biosimilar pipeline report

To listen to Brian's past appearance on Not So Different, 

Asembia

On this episode of Not So Different, Tasmina Hydery and Brian Biehn from AmerisourceBergen discussed results from a recent survey, that were also presented at Asembia 2023, diving into the payer perspective on biosimilars and current pricing trends across the US biosimilar industry.

What AmerisourceBergen's Report Reveals About Payers, Biosimilar Pricing Trends

With 1 adalimumab biosimilar and 3 infliximab biosimilars on the market, and over 10 more biosimilars for rheumatoid arthritis (RA) coming down the pipeline, rheumatologists are about to have more treatment choices for their patients than ever before. 2023 marks the US introductions of biosimilar referencing Humira (adalimumab) and Stelara (ustekinumab). With an abundance of choice, come storage, education, and payer challenges. What can practices do to prepare? How can they boost uptake of these products? And how can we ensure that the lower than anticipated uptake of infliximab biosimilars is not repeated?

Today, I’m speaking with Robert Zutaut, RPh, clinical specialist with McKesson Provider Solutions about the influx of these RA biosimilars and actions that clinicians can take to prepare for the large number of products expected to hit the market in the next couple years. Prior to his work with McKesson, he served as the director of pharmaceutical services at Raleigh Regional Cancer Center in Beckley, West Virginia. He obtained a bachelor of pharmacy from West Virginia University and has been analyzing RA biosimilar trends and the everchanging market. He’s also been keeping an eye on the development for prognostic biomarker tests in the RA space.

To learn more about biosimilars to treat RA, 

To learn more about rheumatologists’ perceptions about RA biosimilars, 

To learn more about incentives for prescribing biosimilars, 

To learn more about infliximab biosimilar adoption, 

To learn more about the influx of adalimumab biosimilars to the US market, 

To learn more about ustekinumab biosimilars, 

Keep a lookout for Robert's upcoming contributor article on the developing RA biosimilar market.

What can practices do to prepare for all the biosimilars to treat rheumatoid arthritis (RA) coming down the pipeline? And how can they ensure that the lower-than-anticipated adoption rates for infliximab biosimilars are not repeated? Robert Zutaut, RPh, from McKesson Provider Solutions, tackles all this and more on this episode of Not So Different.

Pipelines and Preparation: How the US Can Prepare for More RA Biosimilars

Although the oncology space is well-known for having the most successful biosimilar uptake, there are barriers that remain. Community oncologists and patients still have to reckon with pharmacy benefit manager (PBM) and payer formulary decisions, incentives for prescribing reference products, and inflated drug prices. However, community oncology practices have a unique opportunity to help boost biosimilar adoption and create savings for patients.

Today, I’m joined by Mark Guyot, senior director of unity provider engagement at McKesson, to discuss some best practices for biosimilar implementation in community oncology practices. Mark worked on creating and conducting McKesson’s real-world analysis that identified challenges and provided necessary support and education for successful biosimilar adoption. The analysis also led to changes within community oncology practices, resulting in significantly decreased care costs for patients, as well as annual cost savings to Medicare, totaling over $164 million.

To listen to our podcast with Cheryl Vaughn, vice president of clinical services at McKesson, discussed how McKesson's Intrafusion service helps manage infusion sites and aids in the administration of complex biologic drugs, including biosimilars, 

On this episode of Not So Different, Mark Guyot, senior director of unity provider engagement at McKesson, gives an overview of McKesson’s real-world analysis of community oncology practices and their use of biosimilars and offers advice on overcoming adoption barriers and expanding education efforts.

How Community Oncologists Can Break Down Biosimilar Adoption Barriers

Recently, Vizient, a member-owned health care consulting company, published the Winter 2023 edition of its Pharmacy Market Outlook Report. The report commented onthe current trends of the biosimilars market, including the impact that inflation and the COVID-19 pandemic are having on biosimilar utilization and drug prices as a whole. It also discussed the hotly-anticipated US launches of upwards of 8 biosimilars referencing Humira (adalimumab) that are expected throughout 2023 and how issues surrounding payer preferences and white bagging policies could influence the uptake of these products.

On this episode of Not So Differet, we spoke with Carina Dolan, PharmD, MS, BCOP, senior director for clinical oncology and pharmaceutical outcomes at Vizient. Prior to her role with Vizient, she served as a hematology and oncology clinical pharmacist at Baylor University Medical Center. In the past, she’s written for 

®, the written journal associated with our sister site AJMC.com, on the current opportunities and challenges for oncology biosimilars as well as how practices can evolve to better manage expensive immunotherapy options.

To learn more about Vizient’s Pharmacy Outlook Report, 

To read Dr. Dolan’s paper “Opportunities and Challenges in Biosimilar Uptake in Oncology published in 

To read Dr. Dolan’s paper “Evolving Practices in Managing Costly Immunotherapy” published in The American Journal of Managed Care®, 

On this episode of Not So Different, Vizient’s Carina Dolan, PharmD, MS, BCOP, expounds on some of the results from Vizient’s recent edition of its Pharmacy Market Outlook Report, including how inflation could influence biosimilar utilization.

On the Come Up: What Vizient’s Report Says About Inflation and Biosimilars

On this week’s episode, we’re discussing the stresses that practices and clinics face when trying to manage biosimilars as well as some policy considerations that administrators should keep in mind as more biosimilars enter the market and more payers add them to formularies.

I am joined by Kathy Oubre, MS, CEO of Pontchartrain Cancer Center, and a member of The Center for Biosimilars® Advisory Board. She is an expert on the administration and practice perspective of managing biosimilars and has extensive experience supervising a practice that has had to adapt to the growing body of oncology biosimilars that have launched on the US market.

To read more of Kathy’s thoughts on the practice perspective regarding biosimilars, click 

To learn more about automatic substitution policies, click 

To learn more about some of the challenges clinicians could face next year as adalimumab biosimilars enter the market, click 

To learn more about prescription behaviors regarding biosimilars, click 

To listen to another podcast episode on a tool that can improve infusion center efficiency, click 

In this podcast episode, Kathy Oubre, MS, CEO of Pontchartrain Cancer Center, discussed the stresses that practices and clinics face when trying to manage biosimilars as well as some policy considerations that administrators should keep in mind as more biosimilars enter the market and are added to formularies.

Order of Operations: Managing Biosimilars While Maintaining Operational Efficiency

On this week’s episode, we’re taking a look at the impact clinical teams have on biosimilar utilization and patient care within infusion centers. Many infusion medications are biologic drugs and juggling multiple biosimilars for the same reference product can place undue burden on infusion centers and result in medication errors, such as accidentally administering a product not covered by a patient’s insurance. Intrafusion by McKesson’s full management service enables better efficiency within infusion centers and relieves some of the pressure providers and administrators face when trying to manage infusion facilities, including leveraging biosimilars.

Today, I’m joined by Cheryl Vaughn, vice president of clinical services at Intrafusion by McKesson. She has worked closely to develop a robust develop the tool clinical nursing program that accompanies Intrafusion’s full management service and has been with the company for over 5 years. She also has over 8 years of experience working as a registered nurse prior to her time at McKesson.

To learn more about McKesson’s Intrafusion, 

To learn more about biosimilar storage concerns, 

Cheryl Vaughn, vice president of clinical services at McKesson, discussed how McKesson's Intrafusion service helps manage infusion sites and aids in the administration of complex biologic drugs, including biosimilars.

Tools of the Trade: How Intrafusion by McKesson Improves Infusion Center Efficiency, Biosimilar Utilization

On this week’s episode, we’re breaking down the possible impact that Humira biosimilars will have on health policies across the United States. Come 2023, the United States will welcome at least 7 biosimilars referencing Humira (adalimumab) to the market, catapulting the adalimumab market to the number 1 spot as the biosimilars space with the most competitive products referencing the same molecule. One of the biggest concerns regarding these launches is how providers, practices, and payers are going to adapt to ensure that patients have access to adalimumab biosimilars and that practices aren’t overwhelmed trying to keep up with multiple versions of the same product.

The Center for Biosimilars spoke with Chronis Manolis, senior vice president of pharmacy at UPMC Health Plan. He has a lot of experience working in the health plan space, especially regarding policy and relationships with pharmacy benefit managers, a rather contentious topic in present day biosimilar discussions. Manolis is also a proponent of the idea that providers and payers could work together to promote biosimilar use and has been keeping eye on the developing adalimumab space.

To learn more about the hype regarding adalimumab biosimilars in the US, 

To see which biosimilars have been approved by the FDA, 

To read more on PBMs and their influence on biosimilar uptake, 

On this podcast episode, The Center for Biosimilars spoke with Chronis Manolis from UPMC Health Plan to discuss how health care policies may shift as adalimumab biosimilars referencing Humira come to market in 2023, including how providers and payers can ensure equitable access.

Not So Different: How Health Policies May Take Shape in a Post-Humira-Exclusive Adalimumab Market

Pharmacists play an essential role in counseling patients on biosimilar substitution protocols and following state regulations regarding interchangeable medications.

As Biosimilar Substitutions Become More Common, Education and Patient Counseling Are Paramount

People with inflammatory bowel disease (IBD) who switched to the infliximab biosimilar CT-P13 had higher treatment persistence (84% and 91%) than those new to infliximab (66% and 53%), with no new safety concerns.

Patients With IBD Maintain Therapy 2 Years Post Switching to Infliximab Biosimilar

The Department of Veterans Affairs (VA) saved $67 million in 2023 through its strong adoption of biosimilars to curb the high costs of biologic therapies to treat chronic disease.

Psoriasis Biosimilars Saved VA $67 Million in 2023

Elie Bahou, PharmD, highlights how vertical integration in the biosimilar industry streamlines costs, improves supply reliability, accelerates market adoption, and enhances patient access, while emphasizing the value of collaboration, quality control, and value-based contracts for sustainable health care delivery.

How Vertical Integration Drives Innovation and Access in Biosimilars

Elie Bahou, PharmD, senior vice president and system chief pharmacy officer at Providence, discusses strategies to improve equitable access to biologic therapies, including tiered formularies, income-based cost sharing, patient assistance programs, and fostering payer partnerships.

Empowering Vulnerable Populations: The Path to Equitable Biologic Therapy Access

Elie Bahou talks IDNs and biosimilars 1

In an interview, Elie Bahou, PharmD, senior vice president and system chief pharmacy officer at Providence, outlined key barriers to biosimilar adoption within integrated delivery networks (IDNs) and strategies to overcome them. He highlighted provider apprehension and operational hurdles, such as electronic medical record challenges, as significant obstacles.

Bahou also emphasized the importance of strategic payer collaborations, flexible contract terms, and patient and provider education to enhance access to high-cost biologics, reduce disparities, and improve adherence through clear communication of treatment benefits and outcomes.

This transcript has been lightly edited for clarity.

What are the specific barriers to biosimilar adoption within IDNs, and how can IDNs incentivize physicians and pharmacists to prescribe biosimilars over originator biologics?

That's a good question. Doctors typically memorize 10 to 12 medications they're comfortable with. They like to prescribe them over and over. They have the names, they know the side effects, etc. So it's hard to break habits with doctors, as you can imagine. So I would say that provider apprehension or doctor/physician apprehension is there, and we need to educate them on the obstacles of implementing and switching, and the positive aspects of switching. The fact that they're similar drugs called biosimilars, and they save us sometimes 60% of the actual price [of the originator]. And then operational or technical barriers are also some of the challenges with respect to our EMR (electronic medical record) called Epic. 

Even though a doctor prescribes a drug, if the payer, meaning the PBM (pharmacy benefit management) company, does not have that drug biologic on the formulary, they won't pay for it. So that's another complication. How do we mitigate that? We just engage the providers, as I said, to get them comfortable and make them understand the importance of these biologics. We work with the organizational P&T [pharmacy and therapeutics] committee to facilitate adoption of these biologics and to help guide [providers] on prescribing them. 

Then, we use our clinical informatics team to ensure a seamless adoption of these biosimilars, and then we work closely with the manufacturers that make these biologics to bring additional value through contracting. So, those 4 ways are how we mitigate that.

What changes in pharmacy benefit design could lead to a more equitable balance between patient cost-sharing and access to high-cost biologic medications?

Good question. I think one of the best ways to do it is to just develop strategic partnerships with these drug manufacturers by negotiating pricing based on volume purchases, which is what they want, and on outcome. So that includes flexible type of contract terms that allows us to revisit the value and the volume more often to adjust according to market dynamics and payer coverage and then [we have more input with] engagement and policymakers and professional organization for policy type of advocacy. 

So we have a whole government affairs team that really works very hard and lawyers and advocates that work in Washington, DC, to help us with that. And then, provider education—educate the health care providers in our system on the latest evidence-based type of practices to help them pick which biological that's more cost-effective to use for the best optimal outcomes. That's pretty much it. We educate our patients. We make sure that they are aware and understand what the therapy is used for, including potential benefits as well as side effects to enhance their adherence to their medication and their willingness to take it. That's pretty much it in a nutshell.

Videos

Elie Bahou, PharmD, senior vice president and system chief pharmacy officer at Providence, discussed barriers to biosimilar adoption and highlighted strategies such as physician education, streamlined implementation, payer collaboration, and patient engagement to improve access, reduce costs, and enhance adherence to biologic therapies.

Strategies for Improving Biosimilar Access and Utilization

steve pickette talking about biosimilars and AI

Steve Pickette, PharmD, BCPS, chief clinical pharmacist at InpharmD, highlighted the transformative role of artificial intelligence (AI) in managing biosimilars and generics. He explains that AI can significantly reduce the workload for clinical and pharmacy staff by streamlining the analysis required for prescribing and formulary changes, enabling better engagement with health care providers. Additionally, AI enhances pharmacovigilance by monitoring formulary changes, tracking adoption rates among providers, and identifying potential issues.

How can AI help with the prescribing of biosimilars and generics and, can it aid in pharmacovigilance of these products?

Yes, it can aid in prescribing, in reducing the overhead burden of doing the analysis and free up the pharmacy drug information services or clinical staff to engage with the providers. And change management is always a big part of the formulary process—really the most challenging part and it seems like we never have the time to do it. And you get the analysis together as part of the P&T [Pharmacy and Therapeutics Committee], and you get it out there for the doctors, but I rarely would have the time to really engage them and go over it and look at it. So, it really aids in the process in that way.

And then you mentioned the vigilance of seeing how things have gone. That is another area where we never seem to have time. You do a formulary interchange, you've gone through the whole process, you've made the change, and you move to a different product, and then you move on to the next evaluation. And so it's always a kind of a stressor in the back of our minds for those of us that manage formularies. Is it still going okay? Has something changed? I think that's a big benefit of the use of AI-assisted analytic tools, such as what we've built, is it will track and alert you if something has changed or tell you that it's doing well and let you know how things are going. For example, there's a certain set of providers that aren't adopting it. That's another medication use evaluation process that's really challenging, labor-intensive, and time-consuming. So, [this technology] is really promising in all those regards.

Steve Pickette, PharmD, BCPS, emphasizes that AI can streamline prescribing and formulary management for biosimilars and generics, enhance provider engagement, and improve pharmacovigilance by tracking adoption rates and identifying potential issues.

AI-Powered Solutions for Streamlining Biosimilar Prescribing and Monitoring

global biosimilars week webinar

 was hosted by The Center for Biosimilars

 in partnership with the International Generics and Biosimilars Association.

Global Biosimilars Week (GBW) 2024 is an annual campaign designed to raise global awareness about biosimilar medicines and their role in improving patient care and access to affordable treatment options.

This year’s theme, "Advancing Access to Biosimilars," focuses on the progress made over the past two decades surrounding approval, market acceptance and adoption of biosimilars—as well as the challenges that remain in expanding access worldwide. With an effort to highlight the importance of collaboration among health care professionals, patients, stakeholders, and policymakers, the webinar will focus on 

 to advance access to biosimilars and will feature expert discussions on the key barriers to biosimilar uptake in different regions and explore strategies to overcoming these obstacles.



Current global trends in streamlining biosimilar regulatory requirements to foster efficient adoption and market growth.

Strategies to address challenges and improve biosimilar access.

The role of biosimilars in promoting health care sustainability and better patient outcomes.

, assistant managing editor of The Center for Biosimilars (host)

, senior vice president of sciences and regulatory affairs, Association for Accessible Medicines (moderator)

, PhD, Executive Director for Products Evaluation and Standards Setting, Saudi Food and Drug Authority

, PhD, scientist, technical standards and specification unit group lead, norms and standards for biologicals, Health Product Policy and Standards/Medicines and Health Products/World Health Organization 

enior quality specialist, European Medicines Agency

, director, Office of Therapeutic Biologics and Biosimilars Office of New Drugs, Center for Drug Evaluation and Research, FDA

This webinar celebrating Global Biosimilars Week was hosted by The Center for Biosimilars® in partnership with the International Generics and Biosimilars Association.

Webinar: Streamlining the Regulatory Process to Advance Access to Biosimilars

Sophia Humphreys, PharmD, talks about biosimilars

Sophia Humphreys, PharmD, MHA, BCBBS, director of system formulary management at Sutter Health, explains that biosimilar adoption relies on clear strategies in the "buy and bill" medical benefit space. Successful integrated delivery networks (IDNs) collaborate with group purchasing organizations (GPOs) and 340B programs, regularly assess cost factors, and integrate biosimilar tools into electronic health records (EHRs) to simplify prescribing for physicians. Prior authorization processes for both biosimilars and reference products also streamline care. Regular performance reviews and sharing results with leadership help drive continuous improvement in biosimilar uptake.

First, Humphreys notes that we need to differentiate between medical benefit and pharmacy benefit. Many of the most successful biosimilars are in the medical benefit space, especially in the "buy and bill" space. IDNs that work closely with GPOs, 340B branches, and formulary management teams perform regular reviews of coverage, patient mix, and average sales price vs acquisition cost. These analyses help them decide which biosimilars to prioritize. 

Additionally, some IDNs have built biosimilar tools into their EHR systems to streamline physician workflows. Physicians are extremely busy and can’t be expected to remember which product to use each quarter, so it’s important to build support into the system. Some IDNs have also incorporated prior authorization processes for both the reference product and biosimilars, further streamlining care. Finally, it’s crucial to conduct regular performance reviews and share success metrics with leadership. This continuous improvement process elevates the entire system.

Sophia Humphreys, PharmD, MHA, BCBBS, director of system formulary management at Sutter Health, discusses how integrated delivery networks (IDNs) can help drive biosimilar adoption.

How Strategic IDNs Boost Biosimilar Adoption

Dr Lakesha Farmer Discusses Biosimilar Education

Cencora's Lakesha Farmer, PharmD, MBA, discusses efforts that health care organizations can take to better educate patients and providers on biosimilars to improve biosimilar acceptance and achieve cost savings associated with these products.

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