COVID-19 Could Accelerate US Biosimilar Uptake

Although the COVID-19 (coronavirus) pandemic continues to strain the economy and the healthcare system in the United States, Kashyap Patel, MD, the chief executive of Carolina Blood and Cancer Care in Rockhill, South Carolina, said the crisis will likely speed up biosimilar uptake.

Patel, who discussed biosimilars in an interview with The Center for Biosimilars®, is also the vice president of the Community Oncology Alliance and chairman of their Biosimilars Committee.

“As soon as the [COVID-19] pandemic is over, I have a strong feeling that biosimilars will become a preferred choice for the payers as well as for patients, physicians, and the health system as a whole,” Patel said.

Unemployment and Insurance Losses Could Drive Uptake

Currently, 22 million Americans are out of work due to the pandemic. Many of them were on employer-provided health insurance plans. As a result, many patients who rely on costly reference drugs will be left without a way to afford their treatments. Patel believes this could lead patients to search for affordable alternatives such as biosimilars.

Anything that helps patients save, even if the savings is just $5000 or less, would be helpful, Patel said. “That savings will go a long way for patients who lose their insurance and the ability to pay out-of-pocket cost.”

Pandemic May Advance Government Actions

Patel also sees the potential for quicker adoption of legislative bills that support biosimilar uptake as the economy enters a recessionary phase.

“I'm sure that as we go forward, we’ll be worried about the burden on the Treasury for the nation as a whole and the Social Security trust funds. Any and all measures that would help reduce the cost of care without reducing or changing the clinical outcome will definitely be welcome measures across all levels of government,” he said.

COVID-19’s Toll on Practices May Inspire Change

Additionally, the pandemic has caused some health care practices and payers to be understaffed due to an overflow of patients and ill employees, and others. And childcare center closures have forced workers to stay at home, said Patel.

One setback Patel foresees for biosimilars as a result of the pandemic is that “the pre-authorization [process] may become a challenge that could become an impediment to biosimilar uptake,” with the reduced workforce. Payer policies on authorization could present a barrier to the speed at which biosimilar use grows.

Some specialty health care practices are seeing a significant drop in patient visits because some patients don’t want to risk contracting the virus even though health care staff are taking proper precautions to prevent spreading.

“If a practice closes down a satellite location, it may have to cut back on the services, which will create access issues by geographical areas,” Patel said. Alternative infusion centers such as certain hospitals may not be able to provide services either, due to resources being diverted to patients with COVID-19.

However, these issues could spur a movement of health care payment model changes that will favor biosimilar products as a way to lower costs for all stakeholders and increase accessibility.

Patel said the planned Oncology Care First Model follow-up model to the Oncology Care Model is likely to help with cost savings and biosimilar implementation. “ I'm sure many commercial payers will follow the same model because everyone will look at every possible avenue for saving.”