Patt: Payers Could Save More With Biosimilars

“The birth of biosimilars is incredibly important,” but payers are missing an opportunity to save money with them, said Debra Patt, MD, PhD, MBA, a practicing oncologist and breast cancer specialist in Austin, Texas, and executive vice president of Public Policy and Strategic Initiatives for Texas Oncology.

Patt was a featured speaker at The American Journal of Managed Care®'s Patient-Centered Oncology Care^® 2020 virtual conference, and she gave an overview of health care challenges facing the oncology profession and the broader health care community.

“What we have seen is that sometimes there are many biosimilars that enter into the market and that’s a challenge, because what we‘ve encountered is that frequently insurance companies will have a flavor-of-the-month biosimilar among the many choices,” Patt said.

“And if you have 8 biosimilars [for a single reference product], you can’t have insurance companies dictating you use a different biosimilar, because these are very expensive drugs, even if they’re lower cost than the innovator products, and it’s unrealistic to think you can keep multiple biosimilars of an innovator in inventory and manage that inventory at lower cost.”

Keeping all 8 biosimilars in inventory would be incredibly challenging, she explained.

“Payers would have a great strategy and a much lower cost if they’d just embrace any of the biosimilar choices,” Patt said.

In a discussion of President Donald Trump’s health care policies, Patt noted Trump’s midsummer executive orders to rein in the soaring cost of drugs with various initiatives, such as a proposal for index pricing, or benchmarking drug prices to lower cost, international standards; importing drugs from Canada to get around the pricing power of US-based pharmaceutical companies; and an attack on rebates by “eliminating kickbacks to middlemen.”

“So, there’s a strong interest in drug pricing reform and I would say that we’ve seen it on many fronts,” Patt said. Sizing up the 2020 presidential race, Patt said that no matter who is in office in 2021, there is likely to be a significant push for further health care reforms. Both the Trump and Biden election platforms include a health care emphasis, she said. “Drug pricing and cancer care and health care will be a central focus of the election and the next presidency.”

Incorporating new policies, especially when abruptly introduced into the health care system, is highly challenging, Patt said. She noted that more health care policies are likely imminent across the health care spectrum. That combined with dealing with the coronavirus disease 2019 will require flexibility

“We have a long path ahead of us, and it’s important for clinicians and others involved in health care to bridge and reach across to other disciplines to our partners, be it hospitals or insurance companies or administrators and others, to figure out how to navigate this new landscape. It will continue to provide challenges, and I imagine our challenges will be greater in the next few years to come,” Patt said.