Crespi-Lofton Judy, Skelton Jann B
J Am Pharm Assoc (2003). 2017 Sep-Oct;57(5):e15-e27. doi: 10.1016/j.japh.2017.05.014. Epub 2017 Jul 6.
The American Pharmacists Association (APhA) convened the Biologics and Biosimilars Stakeholder Conference on November 30, 2016, in Washington DC. The objectives of the Conference were to determine the key issues and challenges within the marketplace for biologics, follow-on biologics (FOBs), and biosimilars, identify potential roles and responsibilities of pharmacists regarding biologic and biosimilar medications, and identify actions or activities that pharmacists may take to optimize the safe and cost-effective use of biologics and biosimilars.
National thought leaders and stakeholder representatives, including individuals from the Food and Drug Administration, Centers for Medicare and Medicaid Services, a private third-party payer, manufacturers, and several national organizations of health care professionals, participated in the conference. Information shared by this group was supplemented with relevant legal and regulatory information and published literature.
Biologics play a valuable role in the treatment of numerous health conditions, but their associated costs, which tend to be greater than those of small-molecule drugs, place a burden on the health care system. Biosimilars (both noninterchangeable and interchangeable) are highly similar copies of the originator biologic and offer the potential to reduce costs and improve patient access to biological products by increasing treatment options and creating a more competitive market. Despite the potential benefits of biosimilars, certain factors may limit their uptake. The conference participants explored issues that different stakeholders think influence the use of biologics, including biosimilars, in the United States. Barriers included technology, prescriber-pharmacist communication, legislation and regulations, limited patient and health care practitioner knowledge of biological products, patient and health care practitioner perceptions of biosimilars, and evolving science or lack of long-term data. After participants identified issues, they discussed strategies to address these concerns, including the need to enhance the education of pharmacists, prescribers, and patients regarding biologic products, including biosimilars and FOBs; the passage of state laws and regulations that do not impede the use of biosimilars, including interchangeable biosimilars; the use of product-specific tracking information in electronic health records and surveillance systems; bidirectional communication among pharmacists, prescribers, and other members of the care team to support pharmacovigilance and the maintenance of accurate patient records; and the development of evidence-based third-party payer policies.
Patient access to safe and cost-effective treatments is an important goal for the health care system. As the availability and use of biosimilars, including those determined to be interchangeable, increases, their potential to lower costs and improve patient access to treatment grows. However, the extent of such growth is, in part, dependent on various stakeholders' decisions to provide, pay for, or use these products in a safe and thoughtful manner. Ongoing stakeholder collaboration, educational activities, and review of current government or payer policies are required to optimize the uptake of biological products, including biosimilars.
美国药剂师协会(APhA)于2016年11月30日在华盛顿特区召开了生物制品和生物类似药利益相关者会议。会议的目的是确定生物制品、后续生物制品(FOB)和生物类似药市场中的关键问题和挑战,确定药剂师在生物制品和生物类似药方面可能的角色和职责,并确定药剂师为优化生物制品和生物类似药的安全和成本效益使用可采取的行动或活动。
国家思想领袖和利益相关者代表,包括来自美国食品药品监督管理局、医疗保险和医疗补助服务中心、一家私人第三方支付方、制造商以及几个全国性医疗保健专业人员组织的人员,参加了此次会议。该小组分享的信息得到了相关法律和监管信息以及已发表文献的补充。
生物制品在多种健康状况的治疗中发挥着重要作用,但其相关成本往往高于小分子药物,给医疗保健系统带来了负担。生物类似药(包括不可互换和可互换的)是原研生物制品的高度相似复制品,通过增加治疗选择和创造更具竞争力的市场,有可能降低成本并改善患者获得生物制品的机会。尽管生物类似药有潜在益处,但某些因素可能会限制其采用。会议参与者探讨了不同利益相关者认为影响美国生物制品(包括生物类似药)使用的问题。障碍包括技术、开处方者与药剂师的沟通、法律法规、患者和医疗保健从业者对生物制品的知识有限、患者和医疗保健从业者对生物类似药的看法以及不断发展的科学或缺乏长期数据。在参与者确定问题后,他们讨论了解决这些问题的策略,包括需要加强对药剂师、开处方者和患者关于生物制品(包括生物类似药和后续生物制品)的教育;通过不阻碍生物类似药(包括可互换生物类似药)使用的州法律法规;在电子健康记录和监测系统中使用特定产品的跟踪信息;药剂师、开处方者和护理团队其他成员之间的双向沟通,以支持药物警戒和维护准确的患者记录;以及制定基于证据的第三方支付方政策。
患者获得安全且具成本效益的治疗是医疗保健系统的一个重要目标。随着生物类似药(包括那些被确定为可互换的)的可及性和使用增加,其降低成本和改善患者获得治疗机会的潜力也在增长。然而,这种增长的程度部分取决于各利益相关者以安全且审慎的方式提供、支付或使用这些产品的决定。需要利益相关者持续合作、开展教育活动并审查当前政府或支付方政策,以优化生物制品(包括生物类似药)的采用。