title: Biosimilars: Implications for health-system pharmacists.
abstract: OBJECTIVE
  An update on scientific and regulatory challenges in the rapidly evolving field of biosimilar product development is presented.
  
  
  CONCLUSIONS
  The U.S. market for biosimilar products (i.e., highly similar "follow-on" versions of approved biological drugs) is expected to expand with establishment of an expedited-approval pathway for biosimilars similar to that implemented in European Union countries eight years ago. In 2012, the Food and Drug Administration (FDA) published draft guidance clarifying the requirements of the biosimilars approval pathway; although no biosimilar has yet been approved via that pathway, FDA is engaged in ongoing meetings with a number of potential applicants. Due to molecular differences between innovator products and biosimilar versions, biosimilars are highly sensitive to manufacturing changes that can potentially have important safety and efficacy implications. Establishing the interchangeability of biosimilar and innovator drugs may be difficult at first, and it is possible that some biosimilars might not carry all the same indications for which the reference drug is approved. Pharmaceutical cost savings attained through the use of biosimilars are expected to average 20-30%. With several top-selling biologicals likely to lose patent exclusivity by 2020, health systems should prepare for the availability of new biosimilars by addressing formulary management and therapeutic interchange issues, pharmacovigilance and patient safety concerns, and related financial and operational issues.
  
  
  CONCLUSIONS
  Over the coming years, biosimilars will present opportunities for health care organizations to manage the growth of pharmaceutical expenditures. Pharmacists can play a key role in preparing health systems for projected rapid expansion in the use of biosimilars and associated medication-use policy challenges.
authors.affiliation: Steven D. Lucio, Pharm.D., BCPS, is Senior Director, Solutions and Pharmacy Program Development, Novation, Irving, TX. James G. Stevenson, Pharm.D., FASHP, is Chief Pharmacy Officer, University of Michigan (UM) Health System, and Professor, Associate Dean for Clinical Sciences, and Chair, Department of Clinical, Social and Administrative Sciences, College of Pharmacy, UM, Ann Arbor. James M. Hoffman, Pharm.D., M.S., BCPS, is Associate Member, Pharmaceutical Sciences, and Medication Outcomes and Safety Officer, Pharmaceutical Services, St. Jude Children's Research Hospital, Memphis, TN, and Associate Professor of Clinical Pharmacy, College of Pharmacy, University of Tennessee Health Science Center, Memphis.
authors.forename: Steven D
authors.initials: SD
authors.lastname: Lucio
authors.forename: James G
authors.initials: JG
authors.lastname: Stevenson
authors.forename: James M
authors.initials: JM
authors.lastname: Hoffman
mesh_terms: D001688:Biological Products / Q000008:administration & dosage / Q000009:adverse effects / Q000592:standards*; D059451:Biosimilar Pharmaceuticals / Q000008:administration & dosage / Q000009:adverse effects / Q000592:standards*; D017277:Drug Approval; D015195:Drug Design; D006801:Humans; D010330:Patents as Topic; D010595:Pharmacists / Q000458:organization & administration*; D060735:Pharmacovigilance; D010607:Pharmacy Service, Hospital / Q000458:organization & administration; D024382:Professional Role; D014481:United States; D014486:United States Food and Drug Administration
chemical_list: D001688:Biological Products; D059451:Biosimilar Pharmaceuticals