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Session 4: Payers as the Lever to Biosimilars’ Success
Session Chair(s)
Stanton Mehr
Director of Content, Biosimilars Review and Report, United States
US payers are at the nexus of critical leverage points for biosimilar success (or failure). This session will describe how payers are covering biosimilars relative to reference products, patient cost sharing today, and how this trend may be altered with the introduction of adalimumab biosimilars in 2023. We will also touch on how health plans and insurers will try to encourage patients and providers to use adalimumab biosimilars.
Learning Objective :
- Evaluate the power of payers’ formulary positioning in encouraging biosimilar use
- Describe the incentives health plans and insurers use today to encourage biosimilar use
- Analyze the impact of pharmaceutical copay coupons and patient assistance programs on payers’ ability to manage specialty pharmaceutical costs
- Evaluate what interchangeability means for payers in terms of formulary coverage
Speaker(s)
Jennifer Graff, PHARMD
Senior Director, Professional Affairs, Academy of Managed Care Pharmacy (AMCP), United States
Biosimilars on Payers’ Formularies: How are Trends Shifting?
Maggie Brown
Principal, Market Access Strategy Consulting, IQVIA, United States
Trends in Payer Cost Sharing of Biologics and Biosimilars
James Kenney, MBA, RPH
Principal, JTKenney, LLC, United States
What Levers Do PBMs/Payers Have to Encourage Biosimilars When Patients Use Copay Coupons?
Margaret Rehayem, MA
Vice President, National Alliance of Healthcare Purchaser Coalitions, United States
Who Can Influence Payers and PBMs on Biosimilar Decision Making? Employers’ Can!
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