Biosimilars

[bkoffman]

Tom Henry is our CLL pharmacist expert who wrote this perspective on biosimilars that may eventually save some money for CLL and other patients: cllsociety.org/2019/07/appr...

Stay strong. We are all in this together

Brian CLLSociety.org

[LovecuresCLL]

Still a little confused on what a biosimilar is and how does one get prescribed it? Looks interesting and promising to help us.

[bkoffman CLL CURE Hero in reply to LovecuresCLL]

Think of it as a generic for an expensive monoclonal antibody such as Rituximab (Rituxan). Tom Henry explains it is more detail in the link I included.

[cajunjeff in reply to LovecuresCLL]

The difference between a generic and a biosimilar is in the size and complexity of the molecule being copied.

Tylenol (acetaminophen) is a simple molecule, very easy to reproduce exactly. So when you buy generic acetaminophen, you are buying basically the exact same thing as Tylenol.

Rituxumab and other monoclonal antibodies are large molecule drugs, they have a more complex molecular structure than a drug like acetaminophen. It’s hard to create an exact copy of rituxumab. Since the copy drug is similar but not exact, it’s called a biosimilar. So if you take a rituximab biosimilar, you are not taking the exact same drug as rituxumab, but rather a similar drug that, in theory, works just as well.

Biosimilars are still expensive drugs to create, so they are not always a huge discount to the drug they are copying. Since they are not exact copies, some people will still want the original.

[bkoffman CLL CURE Hero in reply to cajunjeff]

All correct, thanks. The hope is that competition will drive down prices, but it doesn't often work that way.

[cajunjeff in reply to bkoffman]

You know Brian, I am skeptical it helps us. I take ibrutinib at 140000 a year. It’s about 12000 a year for me in out of pocket costs.

Suppose a biosimilar ibrutinib costs 100000 instead of 140000. That’s a 40k saving, which is big. But who gets the saving?

My guess is that insurance companies and health providers like Medicare put biosimilars on their formularies and force doctors to give us a biosimilar that is probably as good as the original, but maybe not.

Then I bet they take the savings and I still pay 12000 out of pocket. I certainly could be wrong, and hope I am, but my gut tells me it’s the insurance companies who save the most money on biosimilars and we don’t see much trickle down.

But again, I am just guessing how it might work. We might get a nice saving on our copay. I hope so.

[bkoffman CLL CURE Hero in reply to cajunjeff]

Percent co-pays could be better. That's about it. As they are not done at home most of the time, coverage is usually better.

[LovecuresCLL in reply to cajunjeff]

Thank you Jeff. Excellent explanation as usual. Very clear and concise.