Sign Up Now!
To sign up for our newsletter or print publications, please enter your contact information below.
First Name *
Last Name *
Email Address (Verify) *
We will request your mailing address on the next page.
We will request your mailing address on the next page.

Rapid Biosimilar Adoption Possible in Community Oncology Practice

Web Exclusives - Biosimilars, ASCO Highlights
Chase Doyle
View additional articles by this author

Biosimilars have the potential to create a more sustainable healthcare environment by offering substantial cost-savings and expanding patient access to lifesaving therapies. At the ASCO 2021 virtual annual meeting, Lalan S. Wilfong, MD, Executive Vice President, Value-Based Care and Quality Programs, and Medical Oncologist/Hematologist, Texas Oncology, Presbyterian Cancer Center Dallas, TX, discussed how a community practice model for therapeutic interchange of brand drugs to biosimilars led to a significant increase in utilization of biosimilars and substantial cost-savings over the course of a single year at his institution.

“Biosimilar conversion can be rapidly accomplished via a physician-approved, pharmacist-driven, care-team approach,” he said. “The biosimilar therapeutic interchange processes we have implemented have significant implications for total cost of care and success in our value-based care models.”

According to Dr Wilfong, utilization of biologics is the dominant trend in oncology, accounting for approximately 70% of spending growth.

“Biologics have dramatically altered the care that we provide for our patients, but these drugs are expensive, and controlling total cost of care requires managing the cost of biologics for our value-based programs to succeed,” he said.

Biosimilars, which have been shown to be therapeutically equivalent to brand drugs at much lower costs, offer a solution for achieving substantial cost-savings without sacrificing quality. According to Dr Wilfong, however, therapeutic interchange is complicated by the designation of each biosimilar, which prevents simple substitution.

“Generic drugs can be substituted by a pharmacist without any approval at all because they’re designated generics,” he explained. “The way biosimilars are designated, however, requires both physician approval and patient re-consent for the therapy interchange to occur.”

Successful Biosimilar Adoption

Recognizing the importance of biosimilar substitution to reduce cost, Texas Oncology elected to increase utilization of biosimilars in 2020. Dr Wilfong and colleagues collaborated with McKesson Specialty Health to create educational materials for patients and clinical staff and communicated to all personnel regarding the therapeutic interchange process.

“A central pharmacy team reviewed all new orders and substituted a biosimilar for brand, unless a payer insisted on an origin drug or biosimilar not in the practice formulary,” said Dr Wilfong. “A weekly spreadsheet of all existing patients who would benefit from switching was also generated, and the pharmacy team, based on the indication and payer, would determine if a patient was eligible for therapeutic interchange.”

Following a consultation with the physician, the pharmacist substituted the biosimilar, if it was available. Patients were then educated and re-consented.

After starting with rituximab (Rituxan), Texas Oncology soon added bevacizumab (Avastin) and trastuzumab (Herceptin) to the initiative. Using a comprehensive team approach, Dr Wilfong and colleagues increased the utilization of rituximab from 5% in January 2020 to 80% in December 2020. Utilization of bevacizumab also increased from 9% to 88%, whereas trastuzumab increased from 8% to 74%.

“For just these 3 drugs, we’ve surpassed 85% biosimilar usage in our practice,” said Dr Wilfong. “We’re not at 100%, however, because many payers still require brand-name drugs for various reasons.”

Substantial Cost-Savings

Estimated cost-savings per dose-based average sales price were $550, $850, and $1400 for bevacizumab, trastuzumab, and rituximab, respectively.

“In 1 month alone, the project dramatically reduced cost by 21% ($4 million) by conversion to these 3 biosimilars,” said Dr Wilfong, who noted that additional savings can be realized with the use of biosimilar multidose vials versus single-dose vials. “This is very important to our practice because we are heavily involved in value-based care models.”

Dr Wilfong underscored the multidisciplinary effort needed to successfully deploy the therapeutic interchange of biosimilars for brand drugs.

“This initiative requires the entire care team to be involved because of the difficulty in simply converting patients to biosimilars,” he said. “The drugs have to be substituted, the physician needs to approve, and patients need to be educated and re-consented.”

“It’s a challenge at first, but this comprehensive team approach has real implications in controlling the total cost of care,” he added.

Related Items
New CAR T-Cell Therapy Produces Durable Responses in Relapsed or Refractory Multiple Myeloma
Wayne Kuznar
Web Exclusives published on October 11, 2021 in Multiple Myeloma, ASCO Highlights
Atezolizumab Extends Disease-Free Survival in PD-L1−Positive Early-Stage NSCLC
Phoebe Starr
Web Exclusives published on October 4, 2021 in Lung Cancer, ASCO Highlights
¹⁷⁷Lu-PSMA-617 Prolongs Survival in Patients with Metastatic Castration-Resistant Prostate Cancer
Phoebe Starr
Web Exclusives published on September 20, 2021 in Prostate Cancer, ASCO Highlights
Biosimilars Year in Review Introduction
2020 Year in Review - Biosimilars published on January 24, 2021 in Biosimilars
Establishing Analytical and Clinical Similarity Between HD201 and Trastuzumab
2020 Year in Review - Biosimilars published on January 24, 2021 in Biosimilars
Population-Based, Real-World Data of Neoadjuvant Chemotherapy + Pertuzumab + SB3 in HER2-Positive, Early Breast Cancer
2020 Year in Review - Biosimilars published on January 24, 2021 in Biosimilars
Cost-Savings from Conversion from Reference Pegfilgrastim with On-Body Injector Device to Biosimilar Pegfilgrastim-jmdb in DLBCL
2020 Year in Review - Biosimilars published on January 11, 2021 in Biosimilars
Pharmacokinetic and Safety Equivalence Demonstrated Between HD204, a Biosimilar of Bevacizumab, in Healthy Male Subjects
2020 Year in Review - Biosimilars published on January 11, 2021 in Biosimilars
Utilization and Adherence Among Infliximab Biosimilar Initiators in a US National Commercial Insurance Database
2020 Year in Review - Biosimilars published on January 11, 2021 in Biosimilars
US Oncologists’ Perception of the Efficacy, Safety, and Willingness to Prescribe Biosimilar Cancer Therapies
2020 Year in Review - Biosimilars published on January 11, 2021 in Biosimilars
Copyright © Green Hill Healthcare Communications, LLC. All rights reserved.