Advocates Emphasize Need for Patient Cost Savings From Biosimilars

On Tuesday, leaders of patient advocacy groups presenting at the 2017 AAM Biosimilars Council Conference had a clear message for industry: biosimilar uptake will only happen in earnest when patients begin to see savings on their out-of-pocket treatment costs.

In a panel moderated by Edward Li, PharmD, MPH, BCOP, patient advocates Michele McCourt, senior director of the CancerCare Co-Payment Assistance Foundation; Claire Saxton, MBA, senior director of education for the Cancer Support Community; Laura Wingate, senior vice president of education, support, and advocacy of the Crohn’s and Colitis Foundation; and Christy Gamble, JD, DrPH, MPH, director of health policy and legislative affairs for the Black Women’s Health Imperative, spoke on the patient perspective on biosimilars.

McCourt highlighted the serious impacts of the high cost of care on patients, explaining that she has spoken to paitents who are “doing a lot to stretch their medication” in order to save on costs. Those patients do not achieve their desired or expected outcomes because they are not taking medications as prescribed. “We all know that cancer is an expensive illness…biosimilars coming into the market will reduce overall costs, and we’re hopeful that the reduction in cost to the payers will eventually make their way down to the patient level.” If patients are able to afford to take their drugs as prescribed, McCourt said, they will achieve better outcomes.

According to Gamble, such problems of affordability are even more prominent among communities that already face barriers to access. “We’re recognizing, historically, people of color face significant barriers” to healthcare, Gamble said. “Unfortunately, when biologics came to market they were extremely expensive, insurance companies were refusing to cover these therapies or [requiring patients to pay] out-of-pocket. Patients of color make up a disproportionate number of individuals [who have] lower-incomes,” and they are “resorting to older, outdated treatments with more side effects.” Because of the problem of affordability, Gamble said, “It’s been very difficult to try to get patients of color to look to biologics.” For Gamble, it is critical that the industry recognize that “availability and access are not synonymous.”

Wingate concurred that patients are eager for more affordable biologic therapy: “You’re going to see a greater uptake of biosimilars when the cost savings are passed down to the patient. When those costs reach the patient, you’re going to see a big change in the environment in the [United States].”

When asked by Li whether patients might see an incentive to switch to biosimilars if such a change could eventually lower health insurance premiums overall, Wingate said, “It depends on the patient and where they are.” While patients with the means to pay for their drugs might find such an argument convincing, “If you’re talking to someone who can’t afford their medications,” immediate savings will be the patient’s primary concern. McCourt agreed, saying, “If the patient is stressing over their finances, the overall out-of-pocket is definitely going to be the consideration.”

Patients also need access to better, audience-specific educational materials on biosimilars, the advocates said, in order to feel confident about switching their treatments. According to Wingate, “patients are drivers of change…[Crohn’s and Colitis Foundation focuses on] giving patients the tools to be well educated and making sure the tools are available for all different learning styles. Once they’re educated and they’re seeing the cost savings, that’s when you’re going to get [biosimilar] uptake.”

Saxton agreed with a need for more patient educatoin, saying that an informal poll conducted by Cancer Support Community found that only 18% of respondents knew what a biologic treatment was, “let alone a biosimilar.” For Saxton, “the big push is to get people to recognize what a biosimilar is, and get across the message about safety and efficacy.”

Finally, the advocates called upon the industry to partner with them to learn what is most important to patients, and to develop strategies to deliver cost-saving treatments to the patients who want and need them.