Biosimilar Formulary Strategy
- Preferred biosimilar placement: Place biosimilars on a lower cost-sharing tier than reference biologics
- Reference biologic non-preferred: Move reference biologics to a higher cost-sharing tier
- Step therapy: Require biosimilar trial before approving reference biologic for new starts
- Non-medical switching: Transition stable patients from reference biologics to biosimilars
- Exclusion: Exclude reference biologics when interchangeable biosimilars are available
Non-Medical Switching
Non-medical switching — transitioning stable patients from reference biologics to biosimilars — is safe and effective. Multiple clinical studies show no difference in outcomes between reference biologics and biosimilars for stable patients. Non-medical switching programs that include physician engagement, patient education, and clinical monitoring achieve high adoption rates with minimal adverse events.
Physician Engagement
IQ Insight
Physician engagement is essential for biosimilar adoption. Many physicians are skeptical of biosimilars — often due to manufacturer-funded concerns about immunogenicity and efficacy. Provide physicians with evidence-based information about biosimilar safety and efficacy, and engage them in the formulary change process. Physicians who understand the evidence are far more likely to prescribe biosimilars.