Dr. Brufsky on Ways to Mitigate Cost Before Biosimilars Reach US Market

Adam M. Brufsky, MD, PhD, professor of medicine, associate chief, Division of Hematology/Oncology, co-director, Comprehensive Breast Cancer Center, associate director, Clinical Investigation, University of Pittsburgh, discusses cost mitigation practices that can be implemented before more biosimilars reach the United States market.

Biosimilars are poised to reduce drug costs by at least 15% to 20%, says Brufsky, but it will be some time before the use of more biosimilars becomes prominent practice in this country. In breast cancer, Brufsky is involved with developing the Via Oncology Pathways, but he notes that most of the drugs they use in the network are generic. Before these expensive drugs are introduced, a biomarker predictive of which patients will derive clinical benefit should already be identified.

Other cost-effective strategies should be dedicated to de-escalation. For example, recent data from the PERSEPHONE trial that were presented at the 2018 ASCO Annual Meeting, showed that administering 6 months of trastuzumab (Herceptin) is noninferior to the standard 12-month regimen. In the HER2-positive breast cancer space, another question that needs to be considered is whether pertuzumab (Perjeta) should be given in the adjuvant setting and to identify if there are some patients who will benefit from it more than others.