Biosimilars: US Payer Perspectives (2016)

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Biosimilars have finally hit the US market. Now comes the hard part.

The US Biosimilars market is open for business. What will it take to get customers in the door?

Get our new report, Biosimilars: US Payer Perspectives (2016).

Packed with candid observations from payers, the report explores how biosimilars manufacturers can win over payers and physicians—and get their fledgling commercial strategies off the ground.

Get the information you need to navigate a landscape marked by legal challenges, regulatory hold-ups, and debates over naming, extrapolation and interchangeability. 

“Do we know they’re coming? Yes. Have we been anticipating it? Yes. Do we
know when more biosimilars will reach the US market? Not at the moment.”
Pharmacy Director; Managed Care Organisation 

Answering key questions:

• Progress, but is it enough?: The first biosimilar approved in the US hasn’t really moved the needle with payers. Will the six currently under review—and others on the way—fare better?
• Bring on the lawyers: Originators are waging a two-front legal war to keep biosimilars off the market. Are their strategies working?
• Need for education: Educating stakeholders about biosimilars is a top priority, but whom do payers say should be driving education initiatives?
• Regulatory hold-up: Payers say the US regulatory framework for biosimilars is still missing key pieces. What are they, and which ones will drive adoption?
• Interchangeability questions: What will it take for payers to support switching to interchangeable biosimilars? How is a lack of FDA guidelines on the subject affecting their thinking?
• Naming & labelling debates: Have payers taken a strong position on the naming and labelling of biosimilars? 
• Extrapolation of indications: What is the key to getting payers and physicians on board with the idea of extrapolation? Will the FDA have a role to play?
• Money talks: Will steep discounts guarantee biosimilars a place on formularies? How will originators try to stymie price-based competition?

Vital information for biosimilars manufacturers:

• Find out what payers want: Payers are excited about the potential cost savings biosimilars promise. Find out what they see as the best ways to drive widespread adoption.
• Know the major players: Discover the impact physicians, regulators, and branded drug manufacturers will have on determining the fate of biosimilars in the US market. 
• Assess the impact of regulation: Is the FDA a hindrance or a help for biosimilars. Find out how current regulations are shaping payer opinion and behaviour. 
• Size up the competition: Branded drug manufacturers won’t give up without a fight. Hear what payers think about the tactics they’re using to hold onto their market share.
• Develop a winning commercial strategy: Will price alone dictate uptake of biosimilars? Find out how manufacturers can approach pricing, and what payers think of new reimbursement rules.

Expert Contributors

FirstWord interviewed 10 expert payers from the US between January 27 and February 2, 2016. Respondents have between 5 and 30 years’ experience working in a variety of organisations, including:

• Pharmacy Benefit Managers (PBMs)
• Managed Care Organisations (MCOs)
• Integrated Delivery Networks (IDNs)
• Regional health plans.

All respondents met FirstWord’s stringent screening criteria, and were compensated for participating. To encourage frank and forthright responses, their names have been withheld.

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