Many patients with rheumatic diseases are unsure whether their prescriptions are biosimilars, suggesting more efforts in patient education are needed.
A national survey of individuals with rheumatic diseases found that 28.91% of patients weren’t sure whether they have been prescribed a biosimilar, indicating that there is a lack of knowledge about biosimilars and how they compare with reference products.
Additionally, about 35% of surveyed patients reported that they were prescribed a biosimilar medication.
The survey was conducted in June by Rheumatic Disease Awareness Month 2020 and the American College of Rheumatology (ACR) and its Simple Tasks public awareness campaign.
The survey builds on the ACR’s 2019 National Patient Survey and provides new insights into how issues regarding rheumatic diseases have changed over time, especially during the coronavirus disease 2019 (COVID-19) pandemic.
Trends in Prescription Medication
Prior authorization was required for nearly half (47.94%) of patients, according to the June survey. Previous reports have shown that prior authorization requirements can restrict access to lower-cost medications such as biosimilars and prolong a patient’s waiting period before receiving treatment.
Step therapy requirements affected 46.17% of surveyed patients. Step therapy, also known as fail first therapy, requires patients to begin treatment using therapies preferred by their insurance company—usually less expensive drugs, such as biosimilars and generics—prior to trying a more expensive reference product.
In general, annual median out-of-pocket expenses more than doubled over the past year, rising from $475 in 2019 to $1000 in 2020. Furthermore, in the June survey, 26.68% of patients reported spending more than $2000 in out-of-pocket costs.
COVID-19’s Impact on Treatment
Reported wait times to be seen by a rheumatologist have increased, with 17.13% of patients waiting between 61 to 90 days to get a first appointment with a rheumatologist following a referral, compared with 13.39% in 2019.
“These results could be attributed to factors such as the COVID-19 pandemic, an increase in the number of individuals without health insurance, and the growing nationwide shortage of rheumatology health professionals,” authors of the report wrote.
About 66% of patients reported that they had taken advantage of telehealth within the past year, with 52% of patients citing the pandemic preventing them from being seen in the office as the main reason.
Additionally, from 2019 to 2020 there was a 52% decline in the percentage of respondents who said they were currently being treated by a rheumatology provider. In 2020, 33.53% of patients surveyed said they were currently receiving treatment, compared with 57.41% of respondents in 2019 who said they were being treated by a rheumatology provider. Of those who reported that they were not being treated by a rheumatology provider, 38.23% said they used to be.
FTC Releases Second Report on PBMs Meddling in Generic Drug Markets
January 19th 2025The 3 largest pharmacy benefit managers (PBMs) increased many specialty generic drugs prices by hundreds of percent, with some drugs seeing thousands of percent markups, according to the Federal Trade Commission (FTC)’s second interim report on PBM practices.
Biosimilars Policy Roundup for September 2024—Podcast Edition
October 6th 2024On this episode of Not So Different, we discuss the FDA's approval of a new biosimilar for treating retinal conditions, which took place in September 2024 alongside other major industry developments, including ongoing legal disputes and broader trends in market dynamics and regulatory challenges.
Biosimilars Drive Cost Savings and Achieve 53% Market Share Across Treatment Areas
January 16th 2025Biosimilar launches achieve a 53% market share and a 53% reduction in average drug costs after 5 years of biosimilar competition, according to Samsung Bioepis’ most recent market report, showcasing notable pricing trends and market share disparities across therapeutic areas.
Improving Biosimilar Access Through Global Regulatory Convergence
January 15th 2025Achieving global regulatory harmonization for biosimilar vaccines and immunotherapies is essential to improving market access, reducing costs, and enhancing patient outcomes by streamlining approval processes, fostering international collaboration, and addressing regulatory disparities.
Cost-Efficiency in Action: Denmark's Transition to Biosimilar Adalimumab
January 14th 2025The nationwide mandatory switch from Humira (reference adalimumab) to biosimilar adalimumab in Denmark led to no increase in total health care costs over 9 months, with significant cost reductions for those who switched to GP2017 specifically, highlighting the economic feasibility of biosimilar adoption.