Increasing provider understanding of biosimilars with proactive outreach

As new biosimilars come to market in 2023, it is important to remember that provider hesitation continues to be a barrier to biosimilar adoption. With 80% of providers concerned about reimbursement and 76% worried about patient disruption, providers have cited a variety of factors that may affect their tendency to prescribe these drugs.¹

This hesitation presents an opportunity to help educate providers and support biosimilar preference.

Through our proactive outreach strategies and ongoing expert support, CVS Specialty can better align providers to your plan design strategies and get patients on the appropriate therapy, faster.

Alleviating provider concerns through education

Providers understand the difficulty of onboarding their patients and prescribing specialty medications to them. With new biosimilars entering the market, it can be a lot for providers to juggle.

Our dedicated team of 300+ field colleagues help navigate the complexities of the ever-changing landscape for biologics. We work to simplify patient onboarding by building awareness of new products, educating providers on the latest therapies and offering useful guidance on requirements for accessing these specialty medications.

They regularly engage providers with face-to-face visits and calls to share updates on biosimilars, new medication access, and formulary changes. During these touchpoints, our teams also deliver tailored content focused on building awareness of biosimilars. They help prescribers navigate to the right pharmacy operations team and ensure their office is connected to CVS Specialty technology resources. Our team also connects with providers via letter and fax to inform them of patients experiencing benefit changes.

Through electronic health record (EHR) connectivity, we can streamline point-of-care workflows to verify benefits, perform medication reviews, expedite prior authorizations, and help providers choose clinically appropriate therapies on formulary.

Offering support from therapy experts

CVS Specialty provides direct access to clinicians who support more than 165 specialty conditions and rare diseases. These specially trained pharmacists and nurses advise on appropriate biologics, alternative therapies, and any clinical needs that a provider may have. As more interchangeable biosimilars enter the market, these clinicians will be ready to offer therapy comparisons and additional clarification.

Leveraging this therapy expertise also allows us to communicate patient progress to providers as well as identify any side effects that may affect adherence and/or require intervention.

To help with administrative duties, CVS Specialty CareTeams verify patient benefits, coordinate prior authorizations (PAs), and connect patients to financial resources when needed to support adherence and reduce therapy abandonment.

Supporting plan sponsors as they navigate the biosimilar landscape

CVS Specialty’s coordinated approach to implementing your preferred drug strategy is enhanced through our outreach to providers.

Our biosimilar approach is consistent with our formulary strategy – to drive to low net cost for our clients while providing coverage of clinically safe, effective medications and ensuring continuity of care for members. We believe the most effective low net cost strategy in the autoimmune category will be a combination of the reference product, biosimilar competitors, and other branded products.