3 Patient Access Strategies for New Biosimilar Brands

Biosimilars carry the promise of making treatment options more affordable for patients. To date, 35 biosimilars — including two in 2022 — have been approved by the Food and Drug Administration. According to an Amerisource Bergen report, the pipeline of biosimilars is robust and promising.  

And yet, despite biosimilars offering a lower cost treatment option, some biosimilars currently in the market have struggled to gain market share. Each biosimilar brand launch and medication is unique, but there are two main challenges that biosimilars face as they launch into market: 1) slow adoption from providers and 2) the need for customized, nuanced patient access programs specific to biosimilars.  

A 2020 meta-analysis of prescriber attitudes confirmed anecdotal evidence that provider acceptance in the early years of biosimilars tended to be guarded, likely due to a lack of understanding of what biosimilars are and how to interpret safety and efficacy data. The first biosimilars launched in oncology and immunology, and clinicians in those areas took a while to become comfortable to prescribing them. This suggests a need for pharmaceutical manufacturers to invest in resources to educate prescribers on their product and to counter any confusion in the market.  

3 strategies for gaining biosimilar market share

Data show that it takes about a year for biosimilars to gain traction and market share. Manufacturers need to build out customized, unique patient access programs to help providers feel comfortable prescribing, and patients feel comfortable with switching to and affording the biosimilar drug. In the three patient access strategies below, Truveris’s patient access experts highlight how biosimilar brands can successfully launch and overcome hurdles to achieve long-term success.

1) The design of strategic copay card programs is a critical factor in the success of a biosimilar launch.

Formulary trends favor biosimilars, but PBMs and health systems are reluctant to be the first to remove an originator biologic from its formulary if patients are on it and doing well. So, rather than deny the originator product to existing patients on the biologic, many risk-bearing health systems have begun to favor biosimilars for new treatment starts — a trend already seen in oncology. This is where biosimilar brands can capitalize.

A strategic copay benefit structure can compete with the biologic product that came before it. “The first biosimilar tends to eat up the most market share, so if you’re the first biosimilar, you should focus on having a better strategic copay card than the reference product,” says Jake Powers, Client Experience Manager at Truveris. “But if you’re number three or four, your copay card should focus on having better benefits than the first biosimilar.”  

Biosimilars can be successful in pricing at a higher wholesale acquisition cost (somewhat comparable to the reference biologic) for a branded version or a steep discount for an unbranded version, which would drive higher market share. Running price elasticity models and sensitivity analyses can help brands better understand patient appetite for out-of-pocket costs. In addition, payer appetite for rebates can also help a biosimilar understand the best pricing strategy for their biosimilar drug.  

Because biosimilar regimens are often complex, patients have close relationships with their specialty pharmacies. Consider introducing cards that are honored by specific pharmacies that dispense the product. Those pharmacies will know to check for benefits eligibility and formulary restrictions — a plus for smaller manufacturers without a full-service hub. 

2) Robust analysis of claims data for denials, step edits, and prescription abandonment, can help a new biologic brand understand patient barriers to access.

Are these impediments localized to a particular geography or with a dominant payer? This is a particularly important consideration for manufacturers that hone in on selected PBMs that have relationships with specific specialty pharmacies.

Manufacturers should know which pharmacies a PBM sends the biosimilar to be filled. Data and relationship mapping can help a manufacturer identify the “right” pharmacies to ensure that messaging and uptake of an access program are strong. Therefore, it is critical that pharmaceutical manufacturers have the right partner that delivers detailed claims analyses across payers and pharmacies, helping to make informed decisions about distribution and sales.

3) Tailored patient messaging is a strong way to build biosimilar adherence and loyalty.

This is critical for brands that don’t have the budget for a full-service hub. Using patient messaging tools can be a low-cost, high-yield way of reminding patients about first fills and refills, promoting understanding of the medication and why it’s important to take it, and providing health and wellness tips. Segmented messaging by patient type can further enhance biosimilar brand education efforts and build brand loyalty.

Biosimilar manufacturers must think differently to gain market share.

With low levels of initial prescriber confidence, but incredible promise for the category, it is critical for biosimilar brands to create customized patient access strategies that vary from other specialty brands. Strategic copay cards, analysis of claims data, and patient messaging programs not only increase prescriber confidence, but also push for positive patient adherence, leading to long-term success for brands.  

Truveris is a leading digital health company focused on delivering truth and clarity in pharmacy. Truveris’ proprietary technology, coupled with deep pharmacy expertise, helps to build a more efficient market that maximizes choice, accessibility and prescription drug affordability. Our solutions provide the insight and knowledge to help people lead healthier and more productive lives.