Clint Holland from Sandoz and Arrotex's Hayley Tamborini discussed the need for change to promote biosimilar uptake by adopting a holistic approach that recognises the need for incentives for prescribers, pharmacists and patients.
"I think biosimilar policy is certainly not where it needs to be from our perspective, and we started the work many years ago around introducing reform that we hoped would drive uptake in this market," said Ms Tamborini.
"We're all very well aware of the importance of that, but I guess we still sit here today with little change and no policy that really allows us to see that uptake. I mean, particularly in the community pharmacy setting."
Biosimilar uptake emerged as a policy focus in the Australian Government's 2020 Memorandum of Understanding with Medicines Australia. In 2015, in a decision that led Medicines Australia to refuse to sign a strategic agreement with the Government, a substitution policy was adopted as the base case for all biosimilars.
The uptake of biosimilars has been generally strong in the hospital setting. Less so in the community setting.
Mr Holland said, "In the hospital setting, we've seen some amazing success with biosimilars entering the market with clear reductions in the cost of medicines to Australian patients and taxpayers...But in community pharmacy, I think it's very clear, and you've cited the example there where a particular medicine has a higher cost for a biosimilar than a biologic, and that's symptomatic of the policy position we're in at the moment where we need some substantial change to be able to ensure that one, no patient misses out on therapies, and two, we stop paying too much for medicines we don't need to. So we can invest that funding back into innovative therapies on the PBS."
Ms Tamborini said a persistent challenge is the absence of any patient incentive to switch to a biosimilar. "I think for us in industry and in the space that we work in, we understand that biosimilar uptake, much like generic uptake, has served us well over the years. For Australian patients today, switching to a biosimilar provides no direct benefit. They've often worked very hard to gain access to and had to go through quite an arduous journey of treatment to arrive at being put on that biological medicine. Switching to biosimilars is often a step too far without any clear incentive to do so."
Mr Holland said, "If the government is going to make a substantial change in the uptake of biosimilars, they need to look at incentives that will target the three key stakeholders in this decision. You need an incentive that will drive uptake and acceptance with clinicians and an incentive that will be targeted directly to the patient."
One policy change considered but not adopted in 2015 was to reduce PBS patient co-payments for biosimilars.
Ms Tamborini said another option is to widen patient access to biosimilars.
"Ultimately, we talk about incentives, but its incentives in the context of expanded patient access and more patients being able to access these really important therapies that are otherwise too costly today for this government for more patients to be on."
"I think the changes in the authority and the paperwork are not enough. That's already very clear. We're seeing the removal of that uptake driver slowly over time as we move towards reductions in paperwork for prescribers across the board, which I think is fundamentally a good thing...Suppose we can link the savings generated from a biosimilar to ultimately increasing access and improving funding to certain health groups. In that case, I think the clinician will come along in that journey."
