Reducing Financial Toxicity in GI Cancer Care Through Biosimilars

During a recent interview at an Institute for Value-Based Care^® event hosted by The American Journal of Managed Care^® and Moffitt Cancer Center, Tiago Biachi, MD, PhD, assistant member at Moffitt Cancer Center and associate professor at the University of South Florida, emphasized that biosimilars are essential for enhancing the long-term sustainability of gastrointestinal (GI) cancer care by improving access to advanced treatments at lower costs.

He noted that rising health care expenses and the exclusivity of new drugs contribute to financial toxicity, significantly impacting patients’ quality of life. Biosimilars, particularly in cases of metastatic or advanced cancers requiring ongoing therapies, offer a pathway to equitable and affordable care. Biachi also underscored the importance of clinicians addressing treatment costs with patients and called for dynamic policies to streamline biosimilar development and adoption.

This transcript has been lightly edited for clarity.

Transcript

How can biosimilars improve the long-term sustainability of GI care, especially in the context of rising health care costs?

Well, yeah, unfortunately, we're not doing a great job, for example, with screening or cancer in general. So if we don't screen for cancer, we're going to see more and more patients with advanced disease, where, usually, the treatment is more expensive. When we talk about new technologies, for example, for a diagnosis, or even new technologies for surgical treatment, of course usually they are going to add cost to the treatment. But usually the surgery, it's a 1-time procedure. Even, for example, circulating tumor DNA. Nowadays we have competition, with different companies providing this, and usually this is something that we're going to do every 3 to 6 months.

But when we're talking about drugs, usually once a new drug is released to the market, that company will have the right to commercialize that drug for a few years and we're not going to have competition with that. And usually, of course, new drugs are becoming more expensive. For metastatic disease or advanced cancer, for example, we're going to use this like, every 2 weeks or every 3 weeks, so biosimilars is probably the only way to be able to offer the best treatment for more people. And we're not talking about only about health care here in the US. So probably is the only way to be able to provide the same treatment [as] other countries.

With the increasing number of biosimilars entering the market, how can clinicians ensure that patients with GI cancers have access to more affordable treatment options such as these?

I think every time we're discussing treatment with the patient, we have to be mindful about cost. Sometimes providers don't think about the cost on the other end, and this is really important. Financial toxicity really matters. We have a lot of patients giving up on other aspects of their lives because [of the cost of] cancer treatment, and this is, of course, not good. As I said, biosimilars are one important aspect that can help a lot with this.

Of course, there are a lot of policies that we need to discuss because, as I said, once a company develops a drug, that company will have the exclusivity to commercialize that drug in the market for a few years. So after that period of time, we might have the opportunity to develop biosimilars, but usually, this process is very dynamic.

After a few years, probably that drug is not a best one anymore, so we're going to have another one. And unfortunately, probably then this new one is going to be more expensive. One good example for access, which is something that is really important for cancer care, is immunotherapy, for example. We're using immunotherapy for most of our tumors in the first line, or the refractory setting, and those drugs are pretty expensive.

So we do have some studies, for example, from countries like India, showing that, not biosimilars, but sometimes using very-low-dose of the same medication might have the same benefit for those patients. So this is something that we might need to start thinking about, developing those studies.