How Early Adopters Are Shaping the Future of Biosimilars

Early adopters have played a key role in advancing biosimilar acceptance by sharing real-world data on their successful programs. Sophia Humphreys, PharmD, MHA, BCBBS, director of system formulary management at Sutter Health, a market access strategist and biosimilar expert, emphasizes how these organizations have implemented effective strategies such as pharmacoeconomic analyses and leveraging implementation tools, providing valuable guidance for smaller or rural hospitals with fewer resources. She notes that these pioneers carry much of the initial resistance, making it easier for others to follow.

Humphreys also highlights the importance of integrated delivery networks (IDNs) staying ahead of FDA approvals, updating formularies early, and negotiating favorable contracts with manufacturers or group purchasing organizations (GPOs). She points to ArchMed’s biosimilar-first policy as an example of payer collaboration that has significantly reduced costs and improved patient access. These proactive strategies are essential for fully realizing the potential of biosimilars.

This transcript has been lightly edited for clarity.

Transcript

How have early adopters of biosimilars influenced the overall acceptance of these products?

I think that is a question early on we have asked. For example, Kaiser Permanente has published their data, and Providence has published their data, and so has Yale New Haven and also University Hospitals. They have published how successful their biosimilar programs are, and also how they have implemented these programs in large IDNs in large systems. This is across different therapeutic classes. What this real-world evidence has showed is that there's a lot of common factors that we can learn from. For example, starting early, do comprehensive pharmacoeconomic analysis and use the tools. All of those could help the rest of the industry, and especially for smaller hospitals, rural hospitals, when we do not have as many resources as [others] have, so that that would really help. I always felt like the pioneer would carry most of the resistance and then the rest of us just follow.

What strategies should IDNs employ to effectively incorporate biosimilars into their formularies?

I think, in summary, what we wanted to see is that we wanted to have our IDNs, formulary team, to really watch the FDA approval. I always say you want to stay ahead of the game if you have all of the biosimilars FDA approved evaluated and put them on the formulary, if you determine that they're all comparable, and then that will really support your contracting team when they go out to either request the GPO company for contracting support, or they do individual contract with the biosimilar manufacturers, they can really say that I will be able to move market share if I have a beneficial contract for my IDN. That is one thing that's very important. And also work closely with your payers. Archmed has published their data regularly for their biosimilar-first policy, and they have really significantly reduced their PMPM [per member per month] after they started this particular policy. So they are one of the payers that's really have focused on harvesting the profit of biosimilars for both themselves as well as their patients.