How Automation Will Transform Biosimilar Adoption and Affordability

Understanding the Affordability Gap in Healthcare

Millions of Americans face the daunting choice of whether to afford necessary biologic medications or ration doses to meet their daily needs, a dilemma known as cost-related nonadherence (CRN). This increasingly prevalent issue affects patients managing chronic conditions, where medication costs can escalate rapidly, contributing to the affordability crisis in healthcare. Surprisingly, while there are currently 64 FDA-approved biosimilars on the market— promising lower-cost alternatives to expensive biologics—they only constitute 2-3% of the biologics market in the U.S.

The Promise of Biosimilars: An Overlooked Solution

Biosimilars, which cost approximately 50% less than their brand-name counterparts, hold the potential to save the U.S. healthcare system up to $54 billion over the next decade. This financial relief could significantly impact patients struggling with CRN. However, a lack of awareness concerning these alternatives means many patients unknowingly miss out on potential savings. Moreover, healthcare providers often lack the necessary tools to switch patients to biosimilars, hindering their adoption in practice.

Automation as a Game Changer

One solution lies in leveraging automation to streamline the prescriptive workflow for biosimilars. Automation can assist health practitioners by providing timely notifications when a biosimilar becomes available or is added to a patient’s formulary. Enhanced visibility into these options could equip physicians with the knowledge needed to confidently prescribe biosimilars and ease the administrative burdens that often accompany such transitions.

The Need for Enhanced Physician Awareness

The slow adoption rates of biosimilars share similarities with the initial resistance generics faced when first introduced in the 1980s. Even though biosimilars have been available since 2015, many providers remain uninformed about the various options or logistical steps required to prescribe them effectively. Consequently, many practitioners continue prescribing more expensive brand-name biologics, largely due to a lack of information, guidance, and clarity around the transition process.

Who Suffers the Most?

The CRN phenomenon is notably prevalent among specific groups, revealing disparities in treatment access. Research indicates that 17.8% of adults with asthma report CRN, affecting approximately 2.99 million individuals in the U.S. Among this group, many skip doses or adjust their medication intake in response to high costs—a trend that disproportionately impacts underrepresented communities, including women, older adults, and non-Hispanic Black patients. This underscores the need for targeted policies and solutions aimed at addressing the unique barriers faced by these populations.

The Critical Link Between Nonadherence and Healthcare Costs

The ramifications of CRN extend beyond individual experiences; they ripple through the healthcare system. Studies show individuals who experience CRN are more likely to encounter severe health complications that lead to emergency care. For instance, they are almost twice as likely to suffer from asthma attacks and visit the ER due to related issues than those who stick to their prescribed medications. As biologic medication costs continue to rise, patients would significantly benefit from transitioning to biosimilars—if only physicians could be empowered to streamline this process.

The Role of Concierge Health Practitioners in Adoption

For concierge health practitioners looking to differentiate their practice in an increasingly competitive landscape, understanding and adopting biosimilars could be pivotal. As trusted providers, they have the opportunity to educate patients about the availability of biosimilars and guide them through the transition process. Embracing these lower-cost alternatives not only enhances patient care but also positions practitioners as advocates for affordability in healthcare.

Steps Forward: Enhancing Adoption Through Technology

The evolving landscape of healthcare technology presents a unique chance for concierge health practitioners to utilize automation to promote biosimilar prescription. Innovations, from electronic health records (EHR) updates to real-time alerts about new formulary medications, can facilitate smoother transitions to biosimilars. By embracing these technological advancements, they can help bridge the gap between access and affordability, allowing more patients to benefit from these cost-effective alternatives.

Conclusion: Bridging the Gap for Better Health

Closing the affordability gap in healthcare necessitates a multifaceted approach, with automation playing a crucial role in advancing biosimilar adoption. As healthcare practitioners embrace technology and drive awareness, they also empower their patients to access the medications they need without the heavy financial burden, fostering improved health outcomes across communities. Implementing efficient systems not only aids in patient care but also supports the overarching goal of making healthcare more affordable and equitable.