Does Pharmacist Involvement Impact Rate of Infliximab Biosimilar Switching?

Infliximab biosimilars have been available since 2016.

Although the first infliximab biosimilar product came to market in 2016, uptake of this medication has been slow, attributable to hesitancy among providers to utilize biosimilar agents in chronic disease management.

In a poster presented at the 2022 American Society of Health-System Pharmacists Summer Meetings & Exhibition in Phoenix, Arizona, investigators sought to examine whether the inclusion of an inflammatory clinical pharmacist on patient care teams could promote uptake of infliximab biosimilars.

Through a retrospective cohort study, researchers used electronic medical record data to identify adults with chronic disease managed on infliximab originator or biosimilar product, who received infusions at facilities associated with a large academic medical center. Medications included in the study were originator infliximab (Remicade), infliximab-dyyb (Inflectra), infliximab-abda (Renflexis), and infliximab-axxq (Avsola).

Researchers used prescriber’s National Provider Identifier (NPI) number to assign the prescriber to a group with—or without—pharmacist involvement. The primary study outcome was whether patients who were managed on originator infliximab were switched to a biosimilar product during the study period, and whether providers working at a pharmacist-affiliated clinic were more likely to switch patients to these biosimilar products.

In total, 1069 patients (average age, 46 years) were included in the study, 51% of whom were managed by providers who practiced in pharmacist-involved clinics.

Most patients never received an infliximab biosimilar during the study period: 59% only received originator infliximab; of the remaining 41% of patients, 32% only received a biosimilar infliximab and 9% were switched from the originator to a biosimilar product.

Within the group of patients not managed by a pharmacist-involved provider, only 35% received an infliximab biosimilar, while 26% received only a biosimilar and 9% switched to a biosimilar during the study. Among those managed by providers with pharmacist involvement, 47% received a biosimilar product, 37% received only biosimilars, and 10% were switched to a biosimilar during the study period.

“Regardless of provider-pharmacist involvement, patients were most likely to stay on 1 formulation of infliximab, whether the originator or biosimilar product,” the researchers wrote. “Our findings suggest that pharmacist involvement and collaboration within specialty clinic spaces promotes infliximab biosimilar use.”

“As more high-cost specialty drugs lose patent exclusivity, pharmacist integration into these clinic spaces will be an important cost-savings tool in growing provider comfort with and utilization of biosimilar agents,” they concluded.

Reference

Connolly EC. Impact of clinical pharmacist involvement in infliximab biosimilar switching. Presented at: American Society of Health-System Pharmacists 2022 Sumer Meeting & Exhibition; June 11-15, 2022; Phoenix, AZ. Poster 41-M.