Who’s Teaching Whom in the World of Biosimilars? The Rise of Patient Education

By Kathleen P. Wolff, MBA
Specialty Pharma Journal

As consumers begin to adapt to the high cost of biologic medicines and their biosimilar counterparts, there may be a shift in education, with patients – not providers – leading the way. The concept was posed at the Biosimilars 20/20 conference this summer by featured speaker Bimal Shah, MD, MBA, Service Line Vice President, Premier Research Services, Premier, Inc.

“I would say that there’s a consumer movement, a much more informed consumer, who’s much more sophisticated about understanding their health and actually now having more skin in the game as it relates to what they’re asked to pay for their healthcare,” said Dr. Shah.

In his current position at Premier, Dr. Shah has a front row seat on the evolving biosimilar sector and the reaction of various stakeholders to the changing dynamics. Premier is not only one of the largest group purchasing organizations (GPOs) by volume, with $41 billion in products through its channels per year, the company also does business with 3,400 hospitals and 110,000 other providers.

Premier is closely monitoring the new sector of biological products known as “biosimilars,” approved by FDA as being “highly similar” and defined as having “no clinically meaningful differences in terms of safety and effectiveness from the reference product.”

Adoption of the products in the U.S. is proving to be highly complex, with many legal and regulatory hurdles to overcome. Yet, Dr. Shah believes highly engaged patients may help facilitate the process. “My firm belief is that the patient community is probably going to be educated faster than the provider community. And that just has to do with the speed of information and the engagement … that patients have with their healthcare. Particularly when you’re talking about patients with chronic diseases or terminal illnesses, they are incredible at finding, assimilating information and bringing it back to their provider. And I think you’re going to see some of that also happening where the patients are ahead of the providers.”

Technology also promises to play a growing role, as software providers create new programs that can deliver targeted information via mobile devices.

“I think there’s been a lot of this chatter about precision medicine,” said Shah, referring to the use of genomics and genetics to deliver tailored medicines. “I think we’re at the cusp of having precision education as well. Because now … understanding what chronic diseases patients have, how they’re doing managing it, you can actually deliver … tailored content to the patient as they’re either making good decisions or bad decisions. And so my belief is that the future of education is going to be personal, it’s going to be targeted, and it’s going to be tailored to that individual sort of where they are at that continuum of their health,” Dr. Shah said.

Other speakers at the Biosimilars 20/20 conference agreed. Tom Morrow, MD, Chief Medical Officer, Next IT, who delivered a presentation on technology, takes it a step further, advocating the use of avatars to educate, interact and even help the patient manage his health. “An avatar can talk to you. And we are at the point now where we can have conversations with humans from computers. They are two-way,” he said. “These things can answer 10-thousand questions. More importantly, they can understand the subtle differences between 10-thouand questions. They can do clinical assessments, they can be tied into all kinds of data bases,” Dr. Morrow said. “They can be tied into ecosystems of the user (patient) … and engage in a very, very deep way.”

The topic of who would be responsible for funding and providing the education was also discussed. Dr. Shah’s company, Premier, offers its members “PremierConnect,” an integrated technology and social networking platform, as well as a monthly webinar series featuring key opinion leaders (KOLs), called “Advisor Live.” However, he told the audience that all biosimilars stakeholders have an important role in educating the public to ensure balanced education.

“My real belief is, when you ask whose responsibility it is to educate the public about this (biosimilars), I think it’s everyone in this room,” Dr. Shah said. “I don’t think any of us cannot be culpable in providing that. It’s got to be the providers, it’s got to be the payers, it’s got to be the manufacturers and it’s got to be the PBMs. We are all going to have to share in this, because otherwise, to your point, there will be fragmentation, there will be gaps, and there will be confusion. And that does not ever result in high quality or cost effective care.”

“For a lot of these expensive drugs in complex patients, you’re going to have to have really good partners and trusted partners. And this is where I think the whole specialty pharmacy movement has really gained traction and has really accelerated and exploded. Everyone touts a high-touch model, but what really matters is the outcomes. How many patients at the end of the day are taking the medications, how many are educated about them and how many remain compliant on all those therapies for the (prescribed) duration.”

The conference, hosted by the Specialty Pharma Education Center (SPEC), attracted a substantial number of biosimilar manufacturers, among other stakeholders. Directing his comments to the drug makers, Dr. Shah said education programs will be a factor in determining the success of biosimilar products. “Having those support structures are going to be critical for very unique patient populations, and those populations just happen to be the ones (for whom) a lot of these biosimilars are going to be prescribed.”

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