Since 2014, when Zarxio® was the first biosimilar product approved by the Food and Drug Administration, manufacturers have seemed attuned to the need to two aspects of the launch: (1) pricing and (2) service offerings.
Payers, for example, assumed that the net cost of biosimilars would be lower than the reference product assumption (the question of how much lower was not yet known). They also assumed that biosimilar manufacturers would be prepared to come to market with a set of wraparound services (including “hub” services) that would be competitive with those offered by the reference manufacturer.
Specifically, we’re referring to amenities like patient access to financial assistance and education about the product, and physician-targeted services that might improve prescribing, administration, and ordering of the biologic or biosimilar. From the physician practice perspective, these services can speed prior authorization requests for the product. The reason is simple: If you want physicians to prescribe a biosimilar, it has to be as easy to prescribe as the reference agent; no physician practice wants additional administrative work.
Over the past 5 years, as 17 biosimilars entered the market, these manufacturers approached the wraparound services aspect as a cost of doing business, an aspect of gaining a level playing field. Some biosimilar makers touted their efforts, like Coherus CompleteTM to equal or surpass the reference manufacturer’s services.
For some companies, this package may be more easily bought than created. At last week’s GRx+Biosimilars 2020 virtual conference, Gary Deeb, Senior Vice President, Global Licensing Business Development for Lupin, believes that its wraparound services will not be developed organically. As a generic drug maker entering the biosimilar field, Lupin doesn’t currently offer these services on its individual generic drugs. Recognizing their criticality, Mr. Deeb said, “We’re not set up to offer these services seamlessly to physician offices. We have to adapt and need to understand the therapeutic space. And part B drugs are very different from part D drugs [Lupin usually provides] in terms of services.” He stated, “We may need to go to our partners for these services. We don’t have to do it internally. We just need to recognize that these services will be important.”
Just because a reference manufacturer provides a certain package of services, this does necessarily represent the bar one has to meet, asserted Paul Thomas, Chief Commercial Officer, US, Biocon Biologics. He believes that the wraparound service packages in play today may not be optimal, and perhaps may offer too broad a slate of services. Mr. Thomas said, “Some services are critical and required, others are less so. It’s about separating out what is core to helping the patient versus other services.”
Another factor that may change the equation on wraparound services is the potential for interchangeability, particularly that for insulin. If an interchangeable insulin is brought to the market, and the pharmacy makes the decision to substitute for it, what will be the pushback from providers or patients, if the hub services provided by the biosimilar manufacturer does not match up well with those of the reference drug maker? We won’t know the answer to this until it occurs. But it does sound like some companies, like Biocon, may be willing to test this question.