Factors Affecting Biologics Affordability for Patient Treatment

Kareem Karara discusses several factors impacting the affordability of biologics for patient care pathways.

Kareem Karara, PharmD, BCPS, CCHP: Financial support programs through the manufacturers are an important component in this space to ensure affordability for biologic medications. The impact of the availability of unbranded biologics is interesting, and how that interplays with the patient assistance programs is an evolving area. Given the lack of unbranded biologics in this space, it’s hard to speculate on what other manufacturers may do with respect to patient assistance programs for their pipeline unbranded biologics.

One example of an unbranded biologic on the market is Janssen’s unbranded infliximab [Remicade]. That unbranded biologic has a mirror affordability program. It offers a patient assistance program with a $5 co-pay, which is the same patient assistance program offered for their branded product, Remicade. With the goal of increasing adoption of biologics and unbranded biologics, it would be great to see more manufacturers offer this type of support for their future unbranded biologics.

The impact of rebates in unbranded biologics is very interesting. One strategy that originator manufacturers have used to limit the market penetration of biosimilars is negotiating formulary exclusivity with payers. Unbranded biologics presumably won’t have the same hurdle to overcome in terms of obtaining formulary placement with payers. They offer the potential to have expanded access in the broader marketplace because of a lack of payer hurdles.

Transcript edited for clarity.

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