Increasing Biosimilar Uptake in Rheumatology Clinics Within a Large Academic Medical Center

Biological drugs have revolutionized the treatment of rheumatic diseases, but their high cost has contributed to increased prescription drug spending in the United States. The US Food and Drug Administration has approved the use of several biosimilars, medications that are like their reference biologics with comparable safety and effectiveness, for use in rheumatic diseases. We describe a cost reduction project at a large academic medical center aimed at increasing the use of biosimilars for rituximab and infliximab within rheumatology clinics.

We included patients aged 17 and older with rheumatologic conditions who were prescribed either infliximab or rituximab. A series of educational and electronic health record (EHR) interventions were implemented between 2018 and 2020 to encourage the use of infliximab-dyyb and rituximab-abbs, both biosimilar agents. We measured the change in utilization of these 2 biosimilars between onset of institutional approval through 2023.

During the study period, the overall rate of use of these biosimilars increased from a baseline of <5.0% to 49.4% for infliximab-dyyb and <5.0% to 51.3% for rituximab-abbs. We estimated a total of greater than $3.2 million in cost savings, solely through 2 biosimilar substitutions within 1 specialty clinic at our institution.

Biosimilar use among rheumatology providers in an academic setting can be increased through multimodal interventions including education and EHR modifications. This change has the potential for large cost savings.