Susan Larkin (00:01):
Healthcare is ever-changing and continually evolving, nevertheless it’s additionally private to each employer who provides well being advantages to their staff and each member who wants protection. IBX: The Cowl Story from Independence Blue Cross is the podcast you want for well timed, related conversations about essentially the most essential matters in healthcare protection. Be a part of me, Susan Larkin, govt vp and president of Core Industrial Markets at IBX, as we discover the large image of healthcare and the matters that matter to you most. Let’s bounce proper in to IBX: The Cowl Story.
Reetika Kumar (00:43):
Good day, everybody. That is Dr. Reetika Kumar, senior vp and chief buyer product, medical options, and pharmacy companies at Independence Blue Cross. Welcome to IBX: The Cowl Story. For in the present day’s episode, I’m excited to visitor host a dialog on a subject I’m very enthusiastic about and excited for, and it’s biosimilars. It’s no secret healthcare prices are on the rise and problem everybody, from payers, to employers, to members, and for a minimum of the previous decade, specialty drugs have really pushed these rising prices. Approval of generic drugs, that are precise copies of a reference drug, delivered nice price reductions by intense competitors beginning within the seventies and the eighties. Extra not too long ago, producers have developed and delivered to market comparable low-cost rivals for extra advanced medication, that are biologics, and these are referred to as biosimilars. Like generics, biosimilars are as protected and as efficient as their reference merchandise, however as a result of complexity of the drug will not be the very same as a result of these are biologics, proper? They don’t seem to be chemical compounds. Nonetheless, it’s the identical mechanism of motion, identical high quality, identical effectiveness, however totally different identify and most significantly, a a lot decrease price.
(02:02):
We aren’t new to biosimilars at IBX. We had a biosimilar technique for over a decade now and generated near 200 million in financial savings for our prospects, each with insulins on the pharmacy aspect and with plenty of biosimilars on the medical aspect. And in the present day we’re going to concentrate on Humira. Humira got here to market in 2002 with its first indication for rheumatoid arthritis, and over time has had an growth in variety of indications the place it’s in all probability the primary specialty drug spend with over 20 billion spent yearly simply in the US, and truly a primary specialty drug spend even for us at IBX.
(02:42):
And we’re excited as a result of over the past yr and a half, we now have biosimilars which were accepted by the FDA for Humira, and this represents a chance for us to considerably scale back prices and ship financial savings to our prospects and our members. And I’m excited to share that as of January 1st, 2025, IBX is shifting its members to a single most popular Humira biosimilar technique. And right here in the present day now we have two friends who can speak to us about how employers must be approaching biosimilars with regards to their annual drug spend and the way we’re in a position to ship this win for IBX shoppers and members in an revolutionary approach. Please welcome Helen Sherman, Chief Transformation Officer at Evio, and Julie Bartl, President of Worker Advantages at Johnson, Kendall & Johnson, aka JKJ.
Helen Sherman (03:34):
Thanks for having me be part of this.
Julie Bartl (03:36):
Thanks, Reetika. It’s superb to be right here.
Reetika Kumar (03:38):
I’m so excited to have you ever each right here. I feel that is going to be a enjoyable dialog and hopefully a really informative one for anyone who’s eager about listening to extra about biosimilars. So Julie, I need to begin with you. What are some issues that you simply’ve heard out of your employer teams with regards to biosimilars, however extra broadly, the potential avenues for lowering drug spend?
Julie Bartl (04:01):
Effectively, definitely prescription drug spending is the highest of thoughts for a lot of the employer teams that we work with. With regards to biosimilars, I feel it is a new frontier and all of our employer teams are very keenly eager about studying extra, however not solely educating themselves, but in addition educating their staff and their members on the well being plan that could be affected by a biosimilar introduction.
Reetika Kumar (04:27):
I feel that’s such a essential level as a result of on the plan aspect, we are able to come out with methods, however what we additionally want is perception within the technique, consolation with realizing that it’s a protected technique, and buy-in from the important thing stakeholders. Whereas we work from a member and supplier perspective, we so admire you all being these companions on the desk from an employer perspective after which therefore the employer with the worker. Certainly one of our greatest instruments to deliver down the price of medication is thru {our relationships}, like I mentioned, and thru revolutionary partnerships, contracting and producer negotiations. Helen, are you able to speak about who Evio is and what ought to an HR enterprise companion assume once they hear that IBX is working with Evio?
Helen Sherman (05:13):
Effectively, as your listeners might know, IBX is one among Evio’s house owners, and we companion on many initiatives within the pharmacy house. Core to our pursuits is reworking pharmacy, and including transparency and ease is essential to try this. And our direct buy association with Fresenius Kabi for the biosimilar adalimumab minimizes price and will increase transparency. We’re uniquely positioned to execute this association due to our impartial make-up in addition to the dimensions and density of our buyer markets, and that introduced a novel alternative to place collectively a relationship with Fresenius Kabi and IVC. Our contract with Fresenius Kabi was provided to all of our plans and IBX selected to take part, so we’re glad that IBX members may have a top quality, extra inexpensive therapy choice.
Reetika Kumar (06:14):
I can let you know as somebody who’s been engaged on this technique with the Evio crew and with my inside crew, it’s been thrilling and it provides me hope that we are able to collectively problem the established order and give you new methods of partnering, whether or not it’s with producers on to deliver a decrease price of products for our mutual prospects and our members, and therefore make entry to care that rather more inexpensive. Would you be capable of share why we selected Fresenius Kabi per se, and what are the issues that make this association between IBX, Evio after which Fresenius Kabi, how does that association assist set us up for achievement per se in serving to our members transition to the biosimilar of selection?
Helen Sherman (07:02):
So to start with, what’s coming beneath the pharmacy profit for biosimilars is simply fully landmark within the pharmaceutical house. So with that, it brings alternatives for brand new fashions. And what we’ve put along with Fresenius Kabi and IBX is a groundbreaking mannequin that minimizes the variety of intermediaries, brings the bottom price to the member and the plan. And Fresenius Kabi was keen to do one of these a mannequin. It’s a unique kind of association than working by the same old distribution channels, however it’s yielding considerably decrease prices. And since we’ve stood this up, we’ll be capable of replicate it with different biosimilars and non biosimilars doubtlessly.
Reetika Kumar (07:47):
That’s nice. And what I’ll share is IBX took a short time to give you the Humira biosimilar technique, and it wasn’t as a result of we weren’t centered on it. We deliberately needed it to play out for a bit and somewhat than signal ourselves up for the one or two which can be out there and that we hand over our capacity to cut price. And we’re going with the biosimilar solely technique in 2025 and with Fresenius Kabi can be, they’re a recognized German producer. Proper, Helen? You possibly can hold me sincere. They usually’ve been on this house for a really very long time. And part of our concern was we don’t need to companion with somebody the place entry might turn out to be a difficulty due to provide and demand challenges. And that’s another excuse why we partnered with FK, as a result of we all know primarily based on their observe report and who they’re that that won’t be a priority.
(08:37):
And the primary dose samples being made out there at supplier workplaces, the boots on the bottom really feel like will assist us be extra profitable as effectively in helping suppliers in shifting the member from Humira to the biosimilar, but in addition the zero greenback price share was an intentional association that we made that will make it the place folks can be extra inclined to present the biosimilar an opportunity as a result of it’s pure to be hesitant to maneuver your therapy from a drug that you simply’ve been comfy on, you’re feeling prefer it’s serving to you, to now a brand new drug, particularly should you don’t perceive the medication are very comparable and their mechanism motion may be very comparable. So I’m actually enthusiastic about that. I’m going to pivot to you, Julie. With regards to the Humira biosimilars and the way forward for specialty drug prices, what’s JKJ protecting an eye fixed out for? What are the indicators or indications {that a} payer like IBX is doing the correct issues on specialty medication to ship high quality care and successfully handle prices? And I might say and the way can we proceed to be good companions to you?
Julie Bartl (09:43):
I feel it’s such an essential query, Reetika. So actually after we’re working with our shoppers, we’re 5 key elements, the primary of which is price financial savings. So biosimilars are typically cheaper than the originator product. So Humira on this specific occasion that we’re discussing in the present day. This could scale back the out-of-pocket price for our sufferers and general healthcare spending. Additionally, competitors amongst biosimilars will finally result in additional worth reductions over time. In order that’s one other actually essential piece of this somewhat advanced puzzle. The opposite profit that we search for is elevated entry. So just like what you have been all simply speaking about in phrases on the manufacturing finish, we’re trying to decrease prices, make these extra accessible for sufferers who possibly struggled prior to now to afford Humira. And a few insurance policy have totally different coverages for biosimilars, and people result in fewer entry boundaries. So I feel partnering with IBX and the daring transfer that you simply’re making on this specific space will result in elevated entry and take away that barrier of price.
(10:59):
The third factor we take a look at is equal efficacy and security. We all know that along with your companion set that you simply’re working with, biosimilars are present process rigorous testing. They show that they’re efficient and protected, simply as protected as the unique biologic. So the FDA requires in depth proof to approve biosimilars, and now we have plenty of confidence within the course of that you simply’ve undergone. And possibly not being an early adopter works in your favor as a result of now now we have that confidence and we are able to share that confidence with our shoppers they usually can in the end share that confidence with their members. So a number of biosimilars being out there, this offers us extra therapy choices. That’s crucial. Sufferers, healthcare suppliers have extra decisions and that offers us all extra flexibility and availability of their therapy protocols.
(11:54):
We’re large encouragers of innovation at JKJ. Among the issues that we actually need to be part of is encouraging schooling round these points as a result of it’s advanced and any individual that’s not recognized with a situation that wants a biosimilar or a Humira however finally may have that situation, we would like to have the ability to train them what is on the market available in the market and the way they will get the most effective therapy protocols. These are all actually essential items of working with our shoppers and having constructive outcomes.
Reetika Kumar (12:34):
And I’ll say, I’ll attest to how a lot effort you and your crew put into the schooling piece of it and the collaboration as a result of I’ve had the privilege of becoming a member of a few of your periods the place you’re educating your shoppers, and I do know that type of is your north star the place you need to be certain that there’s well being literacy, however fiscal well being literacy, I’m now coining phrases as we go, nevertheless it comes clear that that’s one thing you all take very critically. And in all honesty, it helps us since you’re participating a client that has belief in you in serving to us achieve success and shifting that price of products whereas making certain finest outcomes for our mutual shoppers.
(13:16):
So I actually admire you each making the time in the present day to speak about biosimilars. I feel it’s actually essential matter in the present day. It’s entrance in thoughts for all of our mixed prospects, and if we are able to attempt to simplify it, take away a few of the myths round it, get folks to be extra comfy with adopting the technique, I feel we’ll all have executed our work right here. However I need to ask every of you, I’ll go together with you first, Helen, is there anything that you simply’d need to share with our listeners earlier than we shut for in the present day?
Helen Sherman (13:49):
No, I might simply echo Julie’s feedback about having confidence in biosimilars, the extent of analysis that goes on on the FDA, and really feel comfy that you simply’re getting a really top quality product at a considerably cheaper price.
Reetika Kumar (14:04):
Julie?
Julie Bartl (14:05):
Sure, I feel the schooling actually is crucial. So not solely does the member or the patron have a duty to study what biosimilars can be found to them, but in addition working with their supplier very carefully, and that suppliers are educated on the protection, efficacy, and the price advantages of the biosimilars. Sufferers must be inspired to ask questions, perceive the biosimilars, that they’re not inferior merchandise, they’re variations of biologics. They’re very completely examined options. I additionally assume it’s crucial to observe responses. So should you have been taking Humira and now you’re taking a biosimilar, it’s okay to maintain observe of that, speak to your supplier about your outcomes and know that there’ll all the time be a substitute for revert again if that’s one thing that completely has to occur, though we don’t anticipate it. However simply the continued collaboration between the payer, the pharmacy, the supplier, and the member, I feel are simply going to be key in having these applications preserve their success over time.
Reetika Kumar (15:08):
Utterly agree with each of you there, and thanks for that viewpoint. I actually imagine that we’re all part of an ecosystem that surrounds that human particular person who has a situation that these medication are going to deal with, and the way can all of us collaboratively work collectively and have type of a synergistic strategy to guarantee that there’s schooling, there’s consolation, there’s a capability to advocate, and we’re undoubtedly right here for that, companions with you on the desk to advocate for our members and our prospects. And clearly agree. I imply, a few of the work we’re doing with Evio is round real-world proof. So we’re all about accumulating the info and seeing how individuals are responding as a result of that solely helps us get higher. And never each human’s equal and the real-world proof work tells us are there sure people that want one thing totally different, proper? And with time, we develop insurance policies round that. So thanks each for becoming a member of us in the present day, and I need to thank our listeners. I hope you loved our dialogue. Please try the present notes for extra info at insights.ibx.com. And thanks once more for becoming a member of us.
