Susan Larkin (00:01):
Healthcare is ever-changing and consistently evolving, however it’s additionally private to each employer who gives well being advantages to their workers 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 important subjects in healthcare protection. Be part of me, Susan Larkin, govt vp and president of Core Industrial Markets at IBX, as we discover the massive image of healthcare and the subjects that matter to you most. Let’s leap proper in to IBX: The Cowl Story.
Reetika Kumar (00:43):
Hi there, 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 at the moment’s episode, I’m excited to visitor host a dialog on a subject I’m very obsessed with 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 at the least the previous decade, specialty medicines have really pushed these rising prices. Approval of generic medicines, that are actual 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 dropped at market comparable low-cost rivals for extra advanced medicine, that are biologics, and these are known as biosimilars. Like generics, biosimilars are as secure and as efficient as their reference merchandise, however because of the 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 substances. 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’re not 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 clients, each with insulins on the pharmacy facet and with plenty of biosimilars on the medical facet. And at the moment 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 enlargement in variety of indications the place it’s most likely 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 have been authorized by the FDA for Humira, and this represents a possibility for us to considerably cut back prices and ship financial savings to our clients and our members. And I’m excited to share that as of January 1st, 2025, IBX is shifting its members to a single most well-liked Humira biosimilar technique. And right here at the moment we have now two friends who can discuss 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 purchasers and members in an progressive 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 believe that is going to be a enjoyable dialog and hopefully a really informative one for anyone who’s fascinated about listening to extra about biosimilars. So Julie, I need to begin with you. What are some issues that you just’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):
Nicely, actually prescription drug spending is the highest of thoughts for a lot of the employer teams that we work with. With regards to biosimilars, I believe this can be a new frontier and all of our employer teams are very keenly fascinated about studying extra, however not solely educating themselves, but additionally educating their workers and their members on the well being plan which may be affected by a biosimilar introduction.
Reetika Kumar (04:27):
I believe that’s such a necessary level as a result of on the plan facet, 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 secure 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. Considered one of our greatest instruments to convey down the price of medicine is thru {our relationships}, like I stated, and thru progressive partnerships, contracting and producer negotiations. Helen, are you able to discuss who Evio is and what ought to an HR enterprise companion suppose after they hear that IBX is working with Evio?
Helen Sherman (05:13):
Nicely, as your listeners could know, IBX is considered one of Evio’s homeowners, and we companion on many initiatives within the pharmacy area. Core to our pursuits is remodeling pharmacy, and including transparency and ease is necessary 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 scale and density of our buyer markets, and that introduced a singular alternative to place collectively a relationship with Fresenius Kabi and IVC. Our contract with Fresenius Kabi was supplied to all of our plans and IBX selected to take part, so we’re glad that IBX members could have a top quality, extra reasonably priced therapy choice.
Reetika Kumar (06:14):
I can inform you 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 convey a decrease price of products for our mutual clients and our members, and therefore make entry to care that rather more reasonably priced. Would you be capable to 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 fulfillment per se in serving to our members transition to the biosimilar of alternative?
Helen Sherman (07:02):
So to begin with, what’s coming underneath the pharmacy profit for biosimilars is simply utterly landmark within the pharmaceutical area. 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 special sort of association than working by the standard distribution channels, however it’s yielding considerably decrease prices. And since we’ve stood this up, we’ll be capable to replicate it with different biosimilars and non biosimilars probably.
Reetika Kumar (07:47):
That’s nice. And what I’ll share is IBX took a short while to give you the Humira biosimilar technique, and it wasn’t as a result of we weren’t targeted on it. We deliberately wished it to play out for a bit and fairly than signal ourselves up for the one or two which can be accessible and that we hand over our capability to discount. And we’re going with the biosimilar solely technique in 2025 and with Fresenius Kabi can be, they’re a identified German producer. Proper, Helen? You possibly can maintain me trustworthy. They usually’ve been on this area for a really very long time. And part of our concern was we don’t need to companion with somebody the place entry could grow to be a problem due to provide and demand challenges. And that’s one more reason why we partnered with FK, as a result of we all know based mostly on their observe report and who they’re that that won’t be a priority.
(08:37):
And the primary dose samples being made accessible at supplier workplaces, the boots on the bottom really feel like will assist us be extra profitable as nicely in aiding suppliers in shifting the member from Humira to the biosimilar, but additionally the zero greenback price share was an intentional association that we made that will make it the place individuals can be extra inclined to provide the biosimilar an opportunity as a result of it’s pure to be hesitant to maneuver your therapy from a drug that you just’ve been snug on, you’re feeling prefer it’s serving to you, to now a brand new drug, particularly for those who don’t perceive the medicine 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 holding an eye fixed out for? What are the indicators or indications {that a} payer like IBX is doing the suitable issues on specialty medicine 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 believe it’s such an necessary query, Reetika. So actually once we’re working with our purchasers, we’re 5 key elements, the primary of which is price financial savings. So biosimilars are usually cheaper than the originator product. So Humira on this specific occasion that we’re discussing at the moment. This may cut back the out-of-pocket price for our sufferers and total healthcare spending. Additionally, competitors amongst biosimilars will ultimately result in additional value reductions over time. In order that’s one other actually necessary piece of this fairly advanced puzzle. The opposite profit that we search for is elevated entry. So much like what you had been all simply speaking about in phrases on the manufacturing finish, we’re seeking to decrease prices, make these extra accessible for sufferers who perhaps struggled prior to now to afford Humira. And a few insurance policy have totally different coverages for biosimilars, and people result in fewer entry limitations. So I believe partnering with IBX and the daring transfer that you just’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 just’re working with, biosimilars are present process rigorous testing. They show that they’re efficient and secure, simply as secure as the unique biologic. So the FDA requires intensive proof to approve biosimilars, and we have now numerous confidence within the course of that you just’ve undergone. And perhaps not being an early adopter works in your favor as a result of now we have now that confidence and we are able to share that confidence with our purchasers they usually can in the end share that confidence with their members. So a number of biosimilars being accessible, this provides us extra therapy choices. That’s crucial. Sufferers, healthcare suppliers have extra selections and that provides us all extra flexibility and availability of their therapy protocols.
(11:54):
We’re huge encouragers of innovation at JKJ. Among the issues that we actually need to be part of is encouraging training round these points as a result of it’s advanced and any person that isn’t recognized with a situation that wants a biosimilar or a Humira however ultimately may have that situation, we wish to have the ability to educate them what is accessible available in the market and the way they will get the perfect therapy protocols. These are all actually necessary items of working with our purchasers 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 training 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 purchasers, and I do know that type of is your north star the place you need to ensure that there’s well being literacy, however fiscal well being literacy, I’m now coining phrases as we go, however it comes clear that that’s one thing you all take very significantly. And in all honesty, it helps us since you’re partaking a client that has belief in you in serving to us achieve success and shifting that price of products whereas making certain greatest outcomes for our mutual purchasers.
(13:16):
So I really admire you each making the time at the moment to speak about biosimilars. I believe it’s actually necessary matter at the moment. It’s entrance in thoughts for all of our mixed clients, and if we are able to attempt to simplify it, take away a few of the myths round it, get individuals to be extra snug with adopting the technique, I believe we’ll all have completed our work right here. However I need to ask every of you, I’ll go together with you first, Helen, is there the rest that you just’d need to share with our listeners earlier than we shut for at the moment?
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 snug that you just’re getting a really top quality product at a considerably lower cost.
Reetika Kumar (14:04):
Julie?
Julie Bartl (14:05):
Sure, I believe the training 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 additionally 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 suppose it’s crucial to watch responses. So for those who had been taking Humira and now you’re taking a biosimilar, it’s okay to maintain observe of that, discuss to your supplier about your outcomes and know that there’ll at all times be an alternative choice to 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 believe are simply going to be key in having these packages keep their success over time.
Reetika Kumar (15:08):
Utterly agree with each of you there, and thanks for that viewpoint. I really imagine that we’re all part of an ecosystem that surrounds that human particular person who has a situation that these medicine are going to deal with, and the way can all of us collaboratively work collectively and have type of a synergistic method to ensure that there’s training, there’s consolation, there’s a capability to advocate, and we’re positively right here for that, companions with you on the desk to advocate for our members and our clients. 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 information 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 at the moment, 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.
