[00:00:00] Stacey Richter: Episode 396. How to answer this question? Will Humira biosimilars reduce drug spend? Today I speak with Anna Hyde.
[00:00:28] Stacey Richter: There are two facets of the Humira biosimilar market and launch that Ana Hyde, my guest today talks about, one is market dynamics, the second is provider and patient confidence. These two concepts are tangled up together and cannot be separated.
But let me back up a sec and explain, although Anna Hyde covers this really well and offers context in the interview that follow. So first facet market dynamics. This means fostering competition, so the price of something goes down. That is the basis of capitalism. After all, you need competition to get in there and try to steal customers from each other by scuffling over price.
In 2023, they're supposed to be 12 biosimilar products for Humira that come out. We'll see scuffling and lower prices. Hmm, maybe not so fast. Second, intertwined facet provider and patient confidence that the biosimilars are as effective and have similar side effects, ie. There is confidence that the biosimilars are actually four wheels interchangeable with the so-called reference product.
I e hum. Bottom line. If providers and patients are not confident in the biosimilar, then no prescribing is gonna happen. Couple those provider and patient clinical concerns with a concern about manufacturer financial assistance. If providers and patients are worried that the out of pocket will be too high, And the biosimilar manufacturers are not gonna offer any financial assistance.
Then again, no confidence, no prescribing. So if either or both of these concerns is present and the no prescribing is the result, this vote of no confidence means there will be no or limited uptake of the biosimilars. And what does the no uptake? It means no lower prices. Having competition per se, isn't gonna lower the prices because the monopoly remains the monopoly.
It's having uptake of the competition that will erode the monopoly. It's having patients who are willing to migrate to the competitive products. And this is pretty vital here because right now there's a lot of cynicism out there about this biosimilar launch and that it is not really going to lower the cost of these drugs much for plan sponsors and you know, is anyone terribly surprised given it sure seems like AbbVie, who is the manufacturer of Humira, still has a lot of dominance in the.
How do they still dominate the market even though their patent thicket years are officially over? You might ask, well, for one, they have payers over a barrel because members who need the Humira molecule are still a hundred percent on Humira. Thus, AbbVie can still demands contract terms for Humira, like the demand that Humira has the lowest patient out of pocket for patients or has an equivalent out of pocket to any formulary biosim.
And this is currently going on from what I understand. Here's a second reason why Humira still dominate the market even after their patents. Expiry is that plans and PBMs are, as Chris Sloan put it in episode two 16. Plan sponsors are addicted to rebates and Humira offers big rebates, which they will likely increase to match any pricing pressure from Biosim.
Here's a quote from the Good Root White paper on this Humira biosimilars business, which is otherwise known as the hottest topic in. Good route says, given the cost rebate power play and the monetary loss that PBMs assume when rebate dollars are removed, we do not anticipate any significant shift to biosimilars or cost savings as Humira biosimilars become available.
So doom, not so fast. The good route White paper continues with this next quote, and this is exactly what Ana Hyde also talks about and gives some historical proof points for. Actually good route says there may be a tipping point in biosimilar pricing, or the net cost differential will be significant enough to force plan sponsors slash payers to make their PBMs prefer the biosimilars.
Biosimilars net priced at 50% or more might be that tipping. And then the white paper says exactly what Ana Hyde also says, and which I reiterated moments ago For this tipping point to happen, this significantly lowered net price must be coupled with a significant shift in market share to make up for the loss of the Humira rebate.
Let me translate that. Provider and patient uptake has to happen here for the prices in this therapeutic category to go down across the board to meet that tipping. Ana Hyde gives some great advice, and this advice is all summed up on a landing page on the Arthritis Foundation website, which we will link to in the show notes.
This landing page includes advice for health plans, and a big part of that advice is to communicate clearly with physicians. And other providers, and also essentially with members and patients. Patients cannot find out that they just got switched to a biosimilar when they get a different box in the mail with a different med, with a different delivery device that they have never seen before with a needle that's gonna pop out from some mystery location.
This is a fail with a capital F for all kinds of reasons that could ultimately undermine the whole operation biosimilar. Some plan is trying to pull off in an effort to try to lower prices to a tipping point so everybody can save money. There is evidence to suggest that over time biosimilars can reduce cost maybe a lot, but for this to happen, it's gonna take really a thoughtful approach filled with bidirectional communication with providers and patients cannot forget.
If everybody's on the same page, it may take a bit, but market dynamics will eventually kick in and prices will go down across the. Everybody wins. My guest today, Anna Hyde is VP of Advocacy and Access over at the Arthritis Foundation. She's a federal lobbyist and helps advance legislation and policies so patients can have better access to affordable medications and specialists.
If you're looking for more insights into topics we discussed today, may I suggest listening to the Encore with Dia Balazsi about copay assistance programs, the show with Chris Sloan about how plans get addicted to rebates. And if you really wanna take a deep dive, a link to a playlist of eight specialty pharmacy episodes in the show notes.
Listen to all of these shows, and you will know more than 99% of healthcare insiders about who is kicking back to who and where the dollar is going in the specialty pharmacy market, which is essential background information if you're planning to evaluate the impact or the potential impact of these biosimilars.
My name is Stacy Richter. This podcast is sponsored by Aventria Health Group.
Anna Hyde, welcome to Relentless Health Value.
[00:07:23] Anna Hyde: Thank you for having me. It's a
[00:07:24] Stacey Richter: pleasure to be here. It is a pleasure to have you. Here we are at a moment. We're having a moment because we have Humira. Is it the biggest selling pharma product ever at this juncture?
[00:07:35] Anna Hyde: Ever? Yep.
[00:07:35] Stacey Richter: Ever? Yeah. Okay. So we have the most revenue generating pharmaceutical product that is going generic, which in the specialty pharmacy world. Getting biosimilars. If we're thinking about a successful biosimilars market, what's that gonna depend on?
[00:07:51] Anna Hyde: I think of a successful biosimilars market in a couple of ways.
There are the market dynamics, of course, between payers, manufacturers, which we of course care about. That's important. But just as important as the other side, which is patient and provider confidence. And I'd love to talk a little bit about both of those. On the market dynamic side, it seems like all we can do these days is complain about the high cost of drugs, and a lot of people talk about competition as this panacea.
It'll be interesting to see how this plays out in other biosimilars that have come to market. And even in arthritis. The molecule infliximab, Remicade went biosimilar a few years ago. So we do have examples of biosimilars on the market now for arthritis. It's just, it's on the medical benefit side, so it's a little bit different.
But what we've seen with that is that both the price of the reference product, Remicade and the biosimilars that have come onto market have all lowered. So in a way, it's doing its job. It has not been perfect. Uptake has not been. Wonderful there. It's growing, but slowly. But we are seeing that downward pressure working now on prices in that space.
There was an interesting study that was done in 2022 that showed the molecules that have higher biosimilar uptake are seeing the more significant price reductions. And so that's part of why we care so much about the biosimilar uptake question.
[00:09:14] Stacey Richter: Lemme just dig into that for. Why would uptake of the biosimilars serve to reduce prices?
[00:09:23] Anna Hyde: It seems to me that that the higher the uptake, the more the pressure to lower the price. This has been true for Remicade where there are now multiple biosimilars on the market. So when the first one came to market, it was like a toe dip in the pool. But now we have several. And so they have to, the, the more there's uptake, the more market share, and then downward pressure that can come from that on that particular market as a whole.
[00:09:50] Stacey Richter: What you're saying is that, If the biosimilars come out and no one is using them, then why would Humira lower their price? Because they effectively, despite the fact they have competition, they sort of don't because everybody wants exactly the branded drug as it stands. Which leads us back to what you had said originally was that there's two pieces to this.
One of them is market dynamics, but then the other one is patient and provider confide. And I can now definitely see why it's really important to talk about patient and provider confidence, because if you don't have patient and provider confidence, then there will be no uptake of the biosimilars.
Therefore, there will be no competition. Therefore, there will be no material. Price pressure. Did I get that right?
[00:10:35] Anna Hyde: That's right, that's right. That's absolutely right. On the provider side, I cannot emphasize enough how important that relationship with the healthcare provider is. The healthcare provider is the top source patients go to for information, not just that they go to, but that they want to go to.
They want to hear about treatments from their providers, and so if you're in the exam room having a conversation about a. Whether you are stable on a reference product or you're a new start and you're trying to figure out what to start on, how the provider talks, A treatment path is gonna impact how you feel and your confidence about that treatment path.
So I think that dynamic is really important. Providers need to be confident of two things. One, that the biosimilar is in fact gonna work just as well as the reference product. And two, that it's actually gonna be available to the patient on formulary. So that's where those. Two pieces, the market dynamic, and then the confidence piece intersect, and both of those need to be moving in parallel.
Providers need to know these biosimilars are available to patients. They're on formulary, they're going to be available, of course, from the patient perspective. At a lower cost, and I am, I feel reasonably confident. The data suggests that these are perfectly safe and that my patient is not gonna have an adverse event from transitioning to this biosimilar.
[00:11:50] Tom Nash: And how are we along that timeline?
[00:11:52] Stacey Richter: It's not like it's a surprise. , this has been coming. If you, you count the, the patent thicket years, this has been coming for a decade, so. You would think that we have had a bit of a headstart getting providers confident or, or where are we?
[00:12:08] Anna Hyde: It's very interesting. It's been this hurry up and wait moment, , because we've been waiting for this for years now.
Right. These biosimilars have been approved since I think 20 15, 20 16. There were. A glut of them that were approved, and we've been waiting all of this time to see them come to market. Meanwhile, they've come to market in other countries, so we've been able to see in Europe, for example, where the Humira biosimilars became available to patients in, I believe it was 2019.
So we have a lot of patient days there. So there's a lot of real world evidence now that doctors have been able to look at, and I think that helps with confidence. I've seen that in conversations with providers that has really. Certainly the experience of remicade com biosimilars coming to market and having that kind of real world experience here in the States has helped.
That matters a lot, but I do think that what's gonna really be the tipping point is having more patient days here in the States. So we now have one that is on market and in the summertime there will be several others that come to market. Hopefully we'll start to see more of that real world evidence here in the States that will help.
Continuously sort of feed that confidence loop
[00:13:19] Stacey Richter: and relative to providers now, and then we'll move on to patients. One of the things that I have heard, correct me if I'm wrong here. Is that even amongst the biosimilars, there may be differences. So it's not just like these are all interchangeable, like in small molecule generics.
Does anybody know what manufacturer the whatever generic the Atorvastatin calcium came from? I have heard that. In the large molecule, i e, the biosimilar space, that there could be differences between the different manufacturers? Is that a thing?
[00:13:51] Anna Hyde: It is a thing and it's a bit of a sticking point. If you look at the different patient and provider communities in this space for new starts, someone who's brand new to a biologic or, or transitioning between biologics starting on a biosimilar, people feel generally comfortable with that, where the sticking point comes in and I'm seeing.
Not necessarily on behalf of the Arthritis Foundation, but just what I've observed is if you're transitioning a patient who is stable on the reference product to a biosimilar, because there are those differences, it is not a perfect one-to-one despite the fact that there are no safety signals in the data to date, and the F D A has approved these as having no clinically meaningful difference.
There's still a concern that there could be some sort of reaction. To transitioning someone who's stable. And I think where a lot of organizations and individual providers and patients are really thinking about that is around interchangeability. And the fact that none of these biosimilars, as of yet on market, at least in autoimmune disease, have that interchangeable designation.
So outside of interchangeability, that allows a pharmacist to automatically substitute. There's still that sticking. I think that a lot of it is an emotional kind of fear of change, tug more so than something that's really rooted in the data or science. And I think that both of those things can be true at the same time, which I would be happy to explore more if you want to.
[00:15:23] Stacey Richter: Sure. So let's explore how there's both an emotional component at play at the same time that there's a belief in the data.
[00:15:30] Anna Hyde: For a person going through an autoimmune disease like rheumatoid arthritis, for example, it's a very tricky disease. It's hard to find something that's gonna work for you. Most patients have to cycle through several drugs before they find one that works.
And the words that we hear patients say when they talk about their disease journey are just wanted to get my life back. I was in the dark. I, I had poor quality of life. I felt lost. I was at rock bottom. These really serious ways of thinking about your life in those moments and when you find something that's working for you, then you hear, I my life back, it would, this is my miracle drug.
Those sorts of things. So there's a real fierce emotional poll to not wanting to quote rock the. That's something that we heard a lot as we were doing some focus groups and patient round tables in preparation for this moment in time, if I tell you that this biosimilar has no clinically meaningful difference and it is expected to have the exact same sort of impact to you and your disease, does that make you feel comfortable about switching to one?
And the answers that we got back were pretty unanimously, no. If I am stable on this medication, why would I want to change? Even if you're telling me it's the same, even with that, You can prod a little bit, and this is true for healthcare providers as well, and show them some of the data points and the real world evidence that exists from other countries, and they'll say, okay, I hear that.
I get that it's supposed to be the same. So there needs to be, that goes back to the confidence building. There needs to be more emphasis on that education and discussion and really treating patients like they're an equal stakeholder at the table so that if they are gonna transition to a biosimilar, They feel like they have a support system.
They know where to go if they have an adverse reaction or if they're afraid they're gonna have one. They have their provider to talk to. There is a support system there for them to be as comfortable as possible as they're making the change.
[00:17:25] Stacey Richter: There's a lot to unpack there. First of all, it definitely sounds like providers will need help and support providing that support network, which traditionally.
Manufacturers have provided, but traditionally generic manufacturers have had nothing to do with like, I could see that this is a whole new world here.
[00:17:47] Anna Hyde: Absolutely. And as we look at it, we sort of feel like every stakeholder has a unique position and responsibility to make sure patients are okay. So for specialty pharmacists, it's if a drug is deemed interchangeable, And you're sort of the arbiter about whether you are going to substitute, you might be that last sort of point of contact with the patient.
And so in our mind, you then have an obligation to proactively talk to the patient about what's happening so that they don't find out they're on a biosimilar because they get a different box in the mail, for example. We also know that all of the injection devices are are gonna be different. There are going to be differences in each product.
And so patients need to have that bridge to make sure that whatever questions they have are answered. We talked about cost being a major factor before, and for better or worse, many patients rely on manufacturer assistance to afford their copays. When we put these scenarios in front of patients and ask them, what questions would you have about transitioning to a biosimilar, one of the top questions that we get back is, is there gonna be manufacturer assistance available?
Is the manufacturer assistance gonna be the same? Is there gonna be somebody who's gonna be able to help me if I need to file an appeal? It's very practical questions about how their life is going to change.
[00:19:03] Stacey Richter: Just to interject there, I meaning to get to this for about five minutes now, , the why of all of this, which has to be the cost.
If the original drug was the same exact price, no one would change. Why would they? It's working great and there's no reason other than the cost. So let's just say that the cost, and again, the cost to who, and I think you brought up a really important point here. If the patient is getting enough manufacturer assistance, that the cost to the patient themselves is far less, even if the overall drug costs far more to their plan sponsor, their employer, or whomever.
But they're sort of insulated from that overall cost. Then, depending on what the plan sponsors choose to do here, like if they, and this happens all the time, we all know, right? You get a pbm, a plan sponsor who puts on formulary a more expensive product because they're addicted to rebates, as Chris Sloan put it in an earlier episode.
Cause they want those rebate. Even if you have a low price generic, but that low price generic doesn't include the rebates. And we're not gonna get into perverse incentives with PBMs here, but it could actually wind up being more expensive for the patient to get the lower priced drug just based on all the crazy stuff with their formulary.
Right. So like some of this also is how are the plan sponsors. What? What's their uptake and how are they thinking through all of this? Just to add a layer of complication on our already layered cake here, ,
[00:20:38] Anna Hyde: and it's not just the cost piece, but it's also the utilization management piece. When we saw Remicade go biosimilar in the beginning, many health plans were requiring patients to step through the reference product before.
getting access to the biosimilar, which effectively shuts the biosimilar out of the market because no provider in their right mind is gonna put you on the same molecule you just failed on. That's another component of it. When we talk to patients, they certainly wanna know and they'll ask those questions, particularly the savvy ones, cost savings to who?
So there has to be a value proposition to the patient, and there also needs to be a recognition to that, to many patients, the value proposition is gonna be zero. I don't care how cheap you make it. I don't care if you make it $0. I don't want to change. I don't want to rock the boat. I keep going back to that in my conversations, in my thinking about this, because that was such an aha moment to me in talking to patients.
It doesn't. That we shouldn't be working towards transitioning patients to biosimilars because we've talked about how I importance that uptake is. It does mean that the way you approach the patient and making sure that they are that equal partner in the process matters a lot with the health plans.
It's something that I'm interested to see how this will unfold over the next few months because a number of major health plans have come out saying that they will offer the Humira biosimilars on formulary. So what is that actually going to look? For the patient, it's not likely that they're gonna go into a provider's office saying, Hey, I really, I heard about these biosimilars and I really wanna take them.
That's probably not going to happen. The cost may come into the conversation if a patient is really cost sensitive, perhaps there's a reason they don't have access to manufacturer assistance. Perhaps they're on Medicare, for example. But then the question is, how much lower is the cost gonna be? How much lower is my out of pocket gonna be and where are all of the savings of the biosimilars?
There's a lot of talk about savings to the system, which could have a positive impact on each player in the system, but what exactly does that look like? What is that impact to the patient? Those are questions that we still have that I think will take time to really untangle
[00:22:42] Stacey Richter: reviewing where we are here In this conversation, we started out talking about market dynamics and the importance of there being uptake of the biosimilars in order for the price of the whole category to diminish.
Then we started talking about provider confidence as well as patient confidence, which is an essential ingredient to this uptake. And if we're thinking about provider confidence and patient confidence, it's probably what we're talking about is maybe three things. Arguably. One is, is the effectiveness of the biosimilars comparable to the reference product, then the adverse events that someone might experience.
And the third thing in this confidence is, is the cost. Is the price of this low enough to make the risk, the uncertainty of the first two things worth it. And obviously you have plan sponsors and formularies who are determining what the patient out of, you know, forget about the cost of the system at this juncture and exactly like, You just said you get patients who just want their miracle drug and they don't necessarily wanna get all involved in what's going on at the kind of macro level, right?
Like they care about their out-of-pockets and you've got plan sponsors and formulary decisions that are being made that very much determine what that patient out-of-pocket is. So you get the plan sponsors then who are very much determining a really critical component of that provider confidence.
Patient confidence. And just one point to ponder in this whole mix is from the provider standpoint, do they have a horse in the race? Like if I'm a provider and now all of a sudden I'm being forced, like depending on what the plan sponsors choose to do, right? Or I decide maybe that I wanna give these biosimilars a try.
Like the why there, for me is a question mark because all I would see from a provider standpoint, Outside of maybe patient adherence, right? Like, because if a patient can now afford the biosimilar because they're much cheaper, then maybe I will be able to put my patients on these drugs and have them stay on the drugs, and my outcomes overall are gonna be better.
But outside of that, . It just, it feels like a whole lot of work for me. Like all of a sudden I have to have a 24 hour hotline and my pharmacists have to work harder. Like there's an amount of work that the provider would need to be up for in this whole mix.
[00:25:07] Anna Hyde: I think a lot of providers feel like they don't have a lot of agency here.
They feel like whether biosimilars are actually gonna be available to patients is gonna be fully dictated by health plans and pb. And therefore it doesn't matter what I prescribe, I can prescribe the biosimilar all day long. If it's not available on the formulary to the patient, I'm gonna have to go right back to the drawing board.
So that administrative burden that you're talking about and the sort of extra work. So I think that needs to be a component too, that's worth exploring more and the conversations that happen between the health plans and the providers in their network. We have a whole set of recommendations we've put out there to, to health plans on facilitating that co communication.
And in addition to communicating with patients well in advance of any sort of transition to a biosimilar or a biosimilar, becoming preferred on formulary, is also having that conversation with the providers because I don't know that providers have a whole lot of confidence right now that they're going to be able to prescribe biosimilars.
And just have that work through the way we all think it should or wanted
[00:26:07] Stacey Richter: it. You're touching upon a really important issue here, this key word communication, which let's just be frank. is not in abundance in the healthcare industry that we have today. We've got providers that aren't talking with each other.
We have payers and Right, like there is such a dearth of communication in general, but as. Problems can be tracked back to a root cause of communication. This sort of sounds like another example of that. You had mentioned that you have some recommendations here for health plans and I'm sure for patients and providers as well.
But let's start with the health plans. What, relative to communication or other things, what are your recommendations here? If you have a health plan, who has decided that the cost savings are worth it and they would like to move down a biosimilar path? Like if I'm a health plan right now, an employer plan sponsor, like whoever I am, what should I be thinking?
[00:27:00] Anna Hyde: Absolutely. So we did a lot of the work already, which I hope is really helpful. We have surveyed our patient community and we've done focus groups as well to really dig into what patients need and want in order to feel comfortable with biosimilars. And some of the things that we got back are if they're going to transition to a biosimilar, they want to know.
I've had a lot of conversations with stakeholders over the past few months where they've come at this with the premise of we're only gonna inform patients if we need to, or does a patient really need to know if they're gonna switch? My answer is, yes. These are savvy people, and so to treat them as such a, I know I've said this several times now, but as an equal player in the decision making, you're gonna start off on the right foot.
What patients told us they want is advanced notice. If a transition to a biosimilar is an option for them, in fact, even before that, knowing that Humira is going off patent, the first question they have is, what is the likelihood that I'm gonna have to switch to one? And if I do switch to one, what is the likelihood that I'm gonna have to switch between multiple biosimilars?
So I think understanding where the patient is coming from and the different questions they have can really help in shaping how health plans communicate with patients. So step one is make sure that you do plan to communicate with them ahead of time, right? Step two is make sure that there's a two way communication feedback loop that's available to patients because they are going to have questions.
These are heavy duty drugs and patients understand. They wanna know where do I go for more information? They wanna have conversations with their health provider, right, about these things. But I also really encourage any stakeholder to point their patients to their respective patient advocacy organization.
So for us, obviously it's. , the Arthritis Foundation, we have an entire landing page full of resources, FAQs, things like that. But there, there are others as well. We co-branded, in fact, a set of recommendations with the National Psoriasis Foundation and the Crohn's and Colitis Foundation. So we're really hitting the top three patient groups for those therapeutic areas indicated for Humira.
We're trying to take some of that guesswork, that work out of it and wanna ourselves create that kind of feedback loop with health. With chief medical officers, with communications officers about what best practices around communication look like. But it's the two-way street. Making sure that patients have some sort of recourse, whether it is a helpline through the health plan, whether it's coming to the arthritis Foundation, going to their healthcare provider.
They have somewhere to go to answer the questions and to have a meaningful conversation about what this is gonna mean to them and to have an opportunity to sort of hear. What that real world data looks like. Patient testimonials. How did this treatment, or how did this change work on somebody like.
That's always really important. Our goal is to keep a feedback loop such that no patient falls through the cracks and gets blind signed in by a switch and doesn't feel like they had any ownership or agency in the matter. And the reason that matters so much to the confidence question is because what we really, really wanted to avoid is the nocebo effect.
And that tends to happen more when a patient feels a lack of confidence about a treatment. That lack of confidence can come from a number of sources. It can come from a conversation in the provider office. So with providers, we say, make sure that you're talking about these things as being clinically the same.
They're FDA approved, as opposed to saying they're cheaper. Or your health plan's gonna require you to take these now it should work the same. How is a patient gonna leave your office feeling? This medication and there's evidence now to suggest this nocebo effect where if a patient feels like the drug isn't gonna work as well, it won't.
It has nothing to do with the sort of clinical outcome. It's really, it really goes back to that kind of emotional component and that almost mind over matter piece. And I think there's an economic argument to be made there. I truly believe that all of the stakeholders in the system, that is the thing that you really want to.
[00:30:56] Stacey Richter: For sure. So just this is summing up some of the really vital points that you just made there. As we have been talking about throughout this entire conversation, patient confidence, provider confidence in these biosimilars is absolutely paramount for. The ability of market dynamics to lower the cost. So if we're thinking about communication as a vital component to enabling patients and providers, nothing for nothing to feel confident in these new products.
Then this is not optional , this communication piece and, and you see it going horribly wrong all the time. And I'm referencing the blood thinner market in North Carolina where all of a sudden you had a P B M do non-medical switching. And did you see Twitter on those days, right? Like the backlash can be insane and probably rightfully so, because again, as you've been saying throughout this entire convers.
You get these patients who are like, this is my life that we're tinkering around with here. So there's definitely a gigantic downside to not communicating well if anyone is interested in the biosimilar market dynamics, actually reducing costs for everyone. And if I'm summarizing your communication advice, I think I'd put it into three categories.
The first one is advanced notice, making sure that patients understand before they get the new box in the mail that this is gonna happen because I could imagine this is your miracle drug and then all of a sudden something different shows up and you are taken completely by surprise. Which could have a negative emotional impact.
But also I hear stories all the time, and you reference this at the top of this conversation, where sometimes the, the device itself is different. And I just heard this story the other day where somebody wasn't sure what the business end of the operation was and wounds up injecting like their finger.
Like if you start out with your entire dose in your thumb and it's painful and it's bleeding, that is not a great start. Right? So advanced. Number two, making sure that there's a two-way communication loop. That there is some kind of helpline, that there's a way to feel supported because as you just said so eloquently, the nocebo effect is very well proven.
And if you have a situation where these patients feel absolutely no support and they got this new, this box in the mail and they don't know what to do with it, like it, it just definitely. It's a handicap right from the very beginning. And then lastly, there are resources that are out there, like other advocacy groups like the Arthritis Foundation.
[00:33:37] Anna Hyde: Absolutely. The Arthritis Foundation's Landing page on biosimilars. Were really aggregating all of this data and all of these resources for patients.
[00:33:45] Stacey Richter: If you were going to give just some top line advice, To end on here, two, let's just say plan sponsors and their ability to communicate with providers and their own members.
If you were gonna sum this up, How would you do it, either relative to the opportunity itself, like this is what we could achieve if this goes well, or relative to some other aspect that maybe you, you feel is the most misunderstood?
[00:34:18] Anna Hyde: Sure. On one hand, I feel like we're at this inflection point. Everybody's talking about specialty drug spending being so high and needing to be control.
What I'm interested to see as more cell and gene therapies come on market, where we're talking about a million plus dollar therapies coming to market, and you're really talking about a health spend problem, we're gonna look back at this moment in the biologic space and say, man, I wish that we had really, really prioritized biosimilar uptake to tamp down that spending while we could so that now we can focus on this other thing.
So that's one piece of it. The confidence piece of it, I feel like. My message would be to not underestimate the importance of the provider and patient confidence in successful biosimilars uptake. Make sure that patients have agency, meaning that they have advanced notice if a biosimilar is going to be an option for them, and that they have recourse to ask questions and make sure that they are comfortable before that new box comes in the mail.
And then the third is to really utilize the resources that are already out there and the hard work that's already been done in sort of curating what patients want to know, who they wanna know it from and when and where they wanna. And the Arthritis Foundation has done a lot of that hard work. I know I keep plugging the af, but I cannot emphasize enough how many aha moments I have had throughout this process in talking to patients and being able to pull that forward into these sort of top line recommendations.
And we've tried to make it really as tactical as possible so that it can re easily be infused in your communication plans.
[00:35:53] Stacey Richter: And we will link to, in the show notes the landing page that Anna, you have referenced. Anna Hyde, thank you so much for being on relentless health value today.
[00:36:03] Anna Hyde: It's been a pleasure.
Thanks for having me.
[00:36:05] Stacey Richter: There are links in the show notes on our relentless health value.com website to every earlier episode that is mentioned in this show. Also, if you go to the website and look at the show notes, I will stick a playlist where if you click on the playlist link, it will just play all the shows that are mentioned.
Thank you so much for listen.