A pharmacist-led program to switch patients to biosimilars at the Mayo Clinic improved access and lowered costs, the clinic's Chelsee Jensen, Pharm.D., said during a presentation today.
In its first year of a biosimilar implementation program, the Mayo Clinic in Rochester, Minnesota, saved $23.1 million. In its second year, Mayo Clinic saved $10.8 million. Chelsee Jensen, Pharm.D.,senior pharmacy specialist, pharmaceutical formulary manager at Mayo Clinic, presented these results at a session at the Academy of Managed Care Pharmacy (AMCP) Nexus 2023 meeting in Orlando.
On Sept. 1, 2020, Mayo began a project to determine whether a pharmacist-led therapeutic interchange and streamlined electronic health records could improve biosimilar adoption. Mayo aimed to switch at all locations from the reference product to five biosimilars: bevacizumab (the biosimilar of anticancer therapy Avastin), epoetin alfa (Procrit to treat anemia in patients with cancer), filgrastim (Neupogen to decrease infection in cancer patients), rituximab (the anti-arthritis medication Rituxan), and trastuzumab (the anticancer therapy Herceptin).
For the first year after implementation, Jensen and her team assessed pharmaceutical wholesale purchase prices from Sept. 1, 2020, through Aug. 31, 2021, compared with data from Sept. 1, 2019, through Aug. 31, 2020.
In that first year, biosimilar use increased 69% for bevacizumab, 63% for epoetin alfa, 80% for filgrastim, 79% for rituximab, and 72% for trastuzumab. Savings in the 12-month post-implementation period totaled $23.1 million across all five biologics. The data for the first-year results were published in Mayo Clinic Proceedings.
During her presentation, Jenkins said one barrier to implementation of biosimilars is what she called “skinny labels,” when a biosimilar is not approved for all the indications of the reference product.
Payer preferences are another barrier now that several biosimilars may be available for a reference product.
“There is an opportunity here for strategies that have been developed collaboratively with payers, and then optimizing your electronic health record, making it as easy to prescribe,” Jensen said.
She said there is an opportunity also for collaboration between the medical and the pharmacy benefit to ensure alignment when patients are transitioning to the biosimilar product.
Patient hesitation is another barrier, but biosimilars present an opportunity to lower costs and improve access for patients, she said.
“We need to keep the needs of the patient at the forefront but also make sure that we are incentivizing, patients making it real for the patient about why we’re transitioning to biosimilars and why that makes sense to them financially as well,” Jensen said. “We need to educate patients that these products are as effective and offer incentives to patients to reduce their out-of-pocket costs, their coinsurance and help keep premiums low for years to come.”
This is a rapidly changing environment. Jensen said to ensure savings, it’s important to monitor the market for biosimilars, including new indications, patent expirations, average sales prices and national guidelines to ensure that electronic health systems are updated.