Taking a closer look at the uptake of bevacizumab, our analyses indicate the uptake of biosimilar products is highly heterogenous at the outlet level. This heterogeneity can likely be attributed to different priorities within each outlet, including financial support, logistics, patient management capabilities, and the physician’s confidence in the performance of new treatments for their patients. There are outlets nearly fully committed to biosimilars, and thus nearly all bevacizumab products in use are biosimilars. But more interestingly, approximately 80% of outlets are managing a combination of originator and biosimilar bevacizumab products, despite the potential logistical challenges of delivering the right drug to the right patient. For those outlets using both, healthcare providers decide who receives a particular drug based on various factors, such as insurance plan design, clinical status of the patient, and availability of products. Furthermore, across the top 100 highest-volume outlets for bevacizumab, there is significant variation in the proportion of biosimilars used – from none-at-all to only biosimilars. This indicates that these trends are not driven by a few large outlets.
The promise of the future biosimilar market is the potential for substantial system savings. As more biosimilar products reach the market, biosimilar spending is expected to reach $16–36 billion by 2024. Despite spending increases, savings are projected to potentially exceed $100 billion over the next five years (Figure 2). There is a wide range of possible savings — from $69 to $140 billion — pending alignment of incentives across different stakeholders, including physician buy-in and shrewd negotiations. It also remains to be seen what competitive actions will be taken by originator companies, and what dynamics will exist in specialty pharmacy biosimilar products — none of which have launched yet.
Although the systemic savings appear promising, there are still concerns when it comes to patient out-of-pocket spending. The prices for patients may still be very high, despite reductions for biosimilars vs. originators.
However, the continued sharing of real-world data by physicians who are commonly prescribing biosimilars will help to increase awareness, encourage wider use, and will likely play a key role in the future of the biosimilars market. In oncology, the uptake of biosimilars in real-world settings is already strong, and with the availability of multiple biosimilars on the horizon, there is great potential for patient-level savings. While there are wider challenges to overcome regarding patient-level prices, biosimilars show the potential to not only save money, but also clear the way for future breakthroughs to reach and benefit patients.
For more information on this topic, view the on-demand webinar – Are we seeing a biosimilars turnaround? – and download the report – Biosimilars in the United States 2020–2024 – all from the IQVIA Institute for Human Data Science.