How pharmacists can drive down drug costs with biosimilars

By the end of 2023, 10 new biosimilars will come to market. And less brand exclusivity means more opportunity to provide efficient, cost-effective care.

For value-based healthcare teams looking to save their patients and their practice money, the time to prepare is now. Research suggests the savings offered by prescribing biosimilars in place of innovator drugs in 2022 alone is projected to reach over $30 billion.

As part of value-based healthcare teams, tech-enabled pharmacists can make it easier for physicians and their patients to see those financial benefits. Here’s how pharmacists can help drive down drug costs with biosimilars.

1. Analyze data to identify which patients will benefit

The availability of biosimilars provides tremendous upside. But in order to take advantage of the cost savings and increased medication adherence these drugs can offer, providers need to analyze a vast amount of data about patient health.

Pharmacists are in a unique position to do this necessary work to identify which patients will benefit from an existing or upcoming biosimilar. And they can make sure physicians are aware of the available drugs that offer those benefits.

Byooviz (the first FDA-approved ophthalmology biosimilar), for example, provides patients significant value. That’s because it’s priced 40 percent lower than the innovator drug Lucentis. For patients with wet macular degeneration, a switch to the biosimilar can mean a savings of more than $10,000 per year.

And with more biosimilars coming to market, healthcare teams can offer more cost-effective treatment to an increasing number of patients throughout their network. Some drugs, like Humira, even treat multiple conditions.

With a biosimilar for Humira upcoming in 2023, pharmacists will be able to offer savings to patients diagnosed with rheumatoid arthritis, psoriasis, and Crohn’s disease.

2. Educate patients about availability, efficacy, and safety

Once the patients who will most benefit from biosimilars are identified, pharmacists determine whether these drugs are covered by their specific insurance formularies – and for which plan of treatment. Humira might be covered for rheumatoid arthritis, for example, but not for psoriasis or Crohn’s.

After determining the treatment will be covered by insurance, pharmacists can flag a patient’s healthcare portal profile so they’re alerted of the biosimilar’s availability the next time they refill a prescription.

Medication management can be confusing – and concerning. Patients need to know how to avoid interactions with other drugs and how to minimize side effects like insomnia. But once they’re comfortable with their prescriptions, patients may be hesitant to switch.

Pharmacists can help patients understand the basics of biosimilars, including…

  • What is a biosimilar?
  • If it’s cheaper, why wasn’t this drug previously an option? 
  • Does this drug actually work?
  • Is it safe?

This information – especially that biosimilars are just as safe and effective as the drugs they can replace – can help make patients more comfortable with biosimilars. Once they’re comfortable, they’re more likely to ask their physician about changing their drug regimen to manage their costs.

By empowering patients with information about biologics, pharmacists take patient education off the plates of their network’s providers.

3. Alert providers about available drugs 

There’s so much going on – in clinics and in hospitals, not to mention the world of R&D – that it’s hard for physicians to know about the particulars of any single biosimilar. And that’s especially true if it’s not part of a treatment plan for their core practice.

Primary care physicians, for example, may not focus on psoriasis. In this case, upcoming biosimilars for Humira might not be on their radar.

When pharmacists update patient portals to set up refill alerts, they can also alert the prescribing physicians about the availability of biosimilars.

So when patients reach out to their doctors, the doctors aren’t surprised – they’re prepared with the same information the patients have, and can already know whether the medications the patients are asking for are right for their prescribed treatment plan.

This means physicians can make the most appropriate choice for the most effective step therapy, saving their patients money by efficiently prescribing the drugs patients need when they need them.

Biologics are a cost-saving step therapy option

Brand exclusivity helps promote the development of new and more effective medications. But exclusive drugs are expensive. Not only that: the more time it takes to find the right medication, the more money it costs the patient. 

That’s why it’s valuable for patients to be able to stay on the medications most appropriate for their treatment – and for healthcare teams to offer the most cost-effective treatment options as they’re available.

Biologics are just as safe and effective as the innovator medications they can replace. That means patients spend less money while on a drug regimen that best fits their healthcare plan. Contact us to learn how RxLive’s pharmacists can help you integrate biosimilars into your prescription program.

Kristen Engelen, PharmD
Kristen Engelen, PharmD, is the chief pharmacy officer of RxLive and a certified consultant pharmacist; she has over a decade of experience in retail pharmacy settings. Kristen became an RxLive co-founder because of her passion for geriatric pharmacy, with a focus on the intersection of pharmacy and aging.