Navigate the Future Brought to You by. One approach to developing biosimilars is to differentiate them in ways such as improving the delivery system, making the drug more convenient for patients, or even focusing on the molecule itself to improve tolerability biobetters. Bio Twitter Latest Posts.
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Suggestions on great podcasts are welcome. Follow SRodger1. Latest posts by Sharon Rodger see all. Case Study: Wichita State University. The forces of globalization have enabled many other nations to work together to promote pharmacovigilance. Automatic substitution complicates the pharmacovigilance that is needed for all biological and biosimilar medicines to ensure safety for patients. Pharmacovigilance is facilitated when physicians make the decision to substitute a biosimilar product. Automatic substitution makes biosimilar pharmacovigilance significantly more difficult. The need to improve and expand pharmacovigilance systems must also be applied to any changes made in originator biologicals since they may also cause unintended outcomes.
Complex and extreme challenges often require creative solutions. An excellent example of this is the development of biobetters.
Biosimilars - A New Generation of Biologics | Jean-Louis Prugnaud | Springer
Where a biosimilar will be a mere structural imitation, a biobetter will possess some molecular or chemical modification that constitutes an improvement over the originator drug. As such, it must be evaluated and approved through the traditional pathway. Such enhancements may range from a longer half-life, allowing for less frequent dosing, to more potency or less toxicity.
That is innovation driven by the new reality of biosimilar competition. And it should not be surprising since, among other things, competition drives innovation. Physicians must practice both the art and science of medicine, but the issue of cost threatens to interpose itself between physicians and patients. While cost is certainly a crucial topic when it comes to health care, it cannot trump patient safety.
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And nowhere is this debate more immediate, urgent, or profound than when it comes to the issue of therapeutic switching, that is, switching patients between products not considered interchangeable. The crucial differences between biosimilars and small molecule generics are that biosimilars are difficult and expensive to get approved, complicated and challenging to manufacture, and generally have a short shelf life.
Reformers need to recognize that policies giving healthcare administrators control over treatment regimes are hazardous to patient health, and actually inflate overall costs. In Europe, regulatory authorities understand that the successful adoption of biosimilars requires physician buy-in and for that reason EMA advises that the physician should be in charge of the decision to switch between the reference product and biosimilar, or vice versa [ 12 ]. Physician confidence translates into increased utilization and in fact, biosimilar medicines have gained a foothold in some European countries as a result of a strategy to persuade physicians to start new patients on a biosimilar rather than switch existing patients [ 13 ].
Adequate physician education, sufficient clinical data and appropriate reimbursement services for physicians will result in greater use of biologicals and biosimilars [ 14 ]. The explosive growth of biological medicines, and the emergence of biosimilars as revolutionary tools to fight the most difficult of diseases, is cause for great celebration in the fight to provide advanced health care to patients worldwide.
By abiding by the general principles of prioritizing patient safety, leveraging the information we know, promoting pharmacovigilance and keeping physicians engaged, a golden age for innovative and affordable health care is within reach. Issues in need of further consideration include, among others, defining proteins, stricter methodology in labelling and naming biosimilars.
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It is important to note that, although beyond the scope of this paper — which focused on switching between biological products — biosimilars can sometimes be used as the initial and only therapy. Also, the manufacture of innovator products can involve changes that require tracking of outcomes. In fact, biosimilar medicines have gained a foothold in some European countries as a result of a strategy to persuade physicians to start new patients on a biosimilar rather than switch existing patients [ 14 ].
The future of biological medicines will be bright if patients, physicians, biotechnology companies, and other stakeholders work together to ensure patient safety is the foremost priority of the biosimilar policy discussion. Then, the future of healthcare debate can move beyond partisan discussion over healthcare access and cost, to a discussion of the diseases that biological medicines can successfully conquer next.
Biologicals and biosimilars are not covered under the Hatch-Waxman Act, which created an abbreviated approval process for generic versions of conventional drugs. On 23 March , however, the Patient Protection and Affordable Care Act was signed in to law and included a pathway for the approval of biosimilars also referred to as the Biologics Price Competition and Innovation Act.
This abbreviated approval pathway for biosimilars gives FDA the authority to define the implementation process. The law also gives FDA the authority to further define the detail regarding scientific standards and the extent of analytical, preclinical and clinical data necessary for the approval biosimilars to ensure patient safety and the effectiveness of the biosimilar.
As FDA moves forward with the process it is important for patients, physicians, pharmacists, and all other stakeholders to be engaged in these efforts to ensure that the top priority for US regulators is patient safety.
Our hope is that the principles outlined in this paper will help them to achieve this worthy goal for patients. The Alliance for Safe Biologic Medicines ASBM is an organization composed of diverse healthcare groups and individuals—from patients to physicians, innovative medical biotechnology companies and others who are working together to ensure patient safety is at the forefront of the biosimilars policy discussion.
It is the mission of the ASBM to serve as an authoritative resource center of information for the public, medical community, FDA and other government staff during the implementation of the biosimilars approval pathway and beyond. Both authors are employed by ASBM. This paper was funded by the Alliance for Safe Biologic Medicines and represents the policies of the organization. References 1. What is a biologic? Center for Biologics Evaluation and Research. What is a biological product? World Preview FDA definitions of generics and biosimilars [ www. Available from: www. Chow SC, Ju C.
Assessing biosimilarity and interchangeability of biosimilar products under the Biologics Price Competition and Innovation Act. Epub ahead of print. Declerck PJ. Biologicals and biosimilars: a review of the science and its implications. Peter P. A problem diagnosed. Center for Medicine in the Public Interest. Eisenberg C, Kupchyk A. Nixon Peabody [homepage on the Internet]. FDA issues biosimilar draft guidance. FDA Alert.
What You Should Know About Biosimilars
Food and Drug Administration [homepage on the Internet]. World Health Organization [homepage on the Internet]. European Medicines Agency [homepage on the Internet]. Questions and answers on biosimilar medicines similar biological medicinal products. Declerck PJ, Simoens S. A European perspective on the market accessibility of biosimilars.
Class JN, Langis L. A patient-centered paradigm for the biosimilars market. Disclosure of Conflict of Interest Statement is available upon request. Permission granted to reproduce for personal and non-commercial use only. Contact the publisher to obtain permission before redistributing.