2. Save on biosimilars
Another cost-saving option is to utilize biosimilar, says Knoer. Unlike generics that are an exact small-molecule chemical copy of brand-names, biosimilars are large-molecule substitutes similar to brand-name biologics—serving the same function without being an exact copy.
According to a study published in the American Journal of Managed Care, biologics made up eight of the 10 top-selling drugs in 2016, compared to just one in 10 a decade ago. From 2009 to 2012, biologics had a 32% increase in prescription volume and a 45% increase in prices, with total spending nearly doubling during that period. The study authors estimate an additional 16% annual increase in biologic spending between 2015 and 2018, according to the report.
Biosimilars could offer relief, and have been used in Japan and Europe for nearly a decade already. A recent Rand Corporation analysis, found that biosimilars will lead to $54 billion less in direct spending on biologics (or about 3% of total spending on biologics) over the next decade.
Development of biosimilars is already under way for some of the top biologics like 2016’s top-selling adalimumab, which generated more than $13 billion in sales, as well as infliximab, etanercept, rituximab, and trastuzumab.
Jeffrey M. Rosner, RPh, senior director of pharmacy sourcing and purchasing at the Cleveland Clinic, says the organization spends $30 to $40 million on infliximab. The hospital system is still investigating pricing for a biosimilar, but Knoer says savings are expected to be significant.
“Because they are newer in the U.S., a lot of physicians are reluctant to use them or are very conservative. But they give us the opportunity for significant savings,” Knoer says, adding that savings could increase further as the FDA approves more biosimilars and competition increases.