PBM Launches Oncology Biosimilar Medical Pharmacy Initiative

Ahead of the anticipated 2019 marketing of FDA-approved anticancer biosimilars in the United States, pharmacy benefit manager (PBM) Magellan Rx Management today announced the launch of an oncology biosimilar program.

The initiative, says the PBM, focuses educating customers, members, and providers “through the implementation of individualized strategies that consider clinical, financial, and regulatory factors.” The result, indicated Magellan, will be to maintain or expand access to effective therapies while delivering savings for its participating customers.

“Magellan Rx is preparing our health plan customers for the upcoming entrance of biosimilars to the oncology category and helping them take advantage of cost savings, while ensuring clinical efficacy and safety, as quickly as possible after the launch of these products,” Kristen Reimers, RPh, senior vice president, specialty clinical solutions, said in a statement. “Our oncology biosimilar initiative takes a multi-pronged approach, including the establishment of plan-specific goals, robust provider education and outreach, and partnership with our customers with the goal to maximize potential savings, minimize disruption, and improve outcomes for patients.”

The PBM says it expects that its new initiative can save $5 million to $8 million per 1 million covered lives, though even more substantial savings may be possible.

The announcement comes close on the heels of Magellan’s recent announcement that its biosimilar management program, which focused on biosimilar infliximab, had resulted in strong biosimilar uptake and significant drug cost savings for health plan organizations during its first year.

According to a statement issued by the PBM in April 2019, the utilization management initiative allowed health plans that took a “comprehensive management approach” (one that switched all patients receiving infliximab for the management of gastroenterological or rheumatological diseases to the biosimilar infliximab Inflectra from the brand-name Remicade) to achieve up to 86% biosimilar use.

Health plans that used a “softer approach,” under which only new patients were asked to use the biosimilar instead of the brand-name Remicade, saw their biosimilar use climb to as high as 75%.

According to Magellan, the switch to biosimilar infliximab saved its health plan members 34% in drug costs for the therapy.