Panelists from multiple biosimilar silos gathered to discuss how to increase the accessibility and affordability of these new drugs in a recent State of Reform “discussing five slides” virtual conversation.
Conversation together Karen van Kauril, Ph.D. , Florida Alliance for Healthcare Value, President and Chief Executive Officer, Omar RashidMD, Surgical Oncologist, Holy Cross Health, and Wayne Wine Garden, Ph.D. , Senior Fellow and Director, Pacific Research Institute Medical Economics and Innovation Center, and State of Reform DJ Wilson.
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During these virtual conversations, panelists share the research and slides they want to emphasize. The first slide focuses on PhRMA research and shows more than 12,000 current biosimilars and other new drugs in clinical trials. Most of these projects are potentially first-in-class. In other words, treat the condition in a new and unique way.
From a policy perspective, Wine Garden said our current drug payment system is “terribly unprepared” to deal with the influx of new drugs.
“We’re talking about incredibly influential treatments … but it’s incredibly dangerous,” he said. “Production is very costly. We are talking about incredibly expensive and incredibly high value numbers, and our payment system is yesterday’s payment system … we Needs much better risk management on the health insurance side. “
In another slide, van Caulil used the Fall 2021 survey of business coalition members of the Florida Alliance for Healthcare Value on the threat of employer-sponsored health insurance. Based on the survey, van Caulil said drug and hospital prices were the number one concern.
To find a payment reform strategy to increase access to biosimilars, van Caulil said some barriers still remain. These include issues with pre-approval of certain drugs or “fail first” policies. This can cause cancer patients to fail the outcome of chemotherapy before accessing biosimilar treatment.
Rashid commented on the direct impact of these barriers on cancer patients. Many are more concerned about bankruptcy than the effects of diagnosis. He also said that patients have difficulty finding even basic screening and treatment options.
“Even those with insurance cannot navigate because the system is so complex … We are developing these resources for us as clinicians. We work with companies and medical care. We are trying to reach out to the system and various community organizations to get them. [navigation] Available resources. ”
According to van Caulil, improving system transparency may lead to better access to these treatments, especially from health plans regarding where biosimilar rebates go.
“If we could install biosimilars, it could be about 30% less than the reference product,” she said. “It should save [health] I’m planning a lot of money. It was a tough fight.I have countered the wrong information that is coming [to our members.]”
See full discussion here..
