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Dr. Michael Klufas

3yr
The advent of anti-VEGF biosimilars

Anti-VEGF therapies effectively treat retinal disease. By blocking VEGF signaling, they target vascular permeability, angiogenesis, and inflammatory responses. The advent of anti-VEGF therapies has improved patient outcomes in neovascular age-related macular degeneration (nAMD), macular edema after retinal vein occlusion (RVO), myopic choroidal neovascularization (mCNV), and diabetic macular edema (DME). However, reference products are expensive for both patients and healthcare systems.

Biosimilars help decrease the price of these important ophthalmic agents thereby increasing access to more patients. Financial savings from biosimilars not only increase patient access but may also help improve adherence and health outcomes.

What is your clinical experience with anti-VEGF biosimilars? What considerations do you make when prescribing these agents?

  • 3yr
    I do not see the clinical benefits that biosimilars offer to the current armamentarium of options available.
  • 3yr
    I am excited to learn more about biosimilars, but I would say at this point the jury is still out. I am optimistic about advances in this field and hopeful they will be of benefit many of my patients in the near future!
  • 3yr
    I am wary of biosimilars to date. I have not been pressured to use by payors, but this is likely imminent. If the main objective is to save healthcare dollars, can use bevacizumab therapy. The biosimilar pricing is just a 20% discount on branded medication.
  • 3yr
    I am excited about the growth in this pharmaceutical area... IF the cost is significantly less than the current therapeutic agents. I would welcome new biosimilars offering Improved efficacy compared to Avastin with less cost compared to current name-brand medications.
  • 3yr
    Like other rheum dz, only time will tell if these are equally effective w a cost savings.
  • 3yr
    I think that current biosimilars do not offer a meaningful price differential compared to the originator product. Where cost is a major concern, Avastin is a better option. While I have not seen/heard of safety issues, I think we are all watching closely to be sure that the quality controls of these new products are up to par. We are seeing some payors require use of a biosimilar, and I expect this to continue/expand and this will be the major driving force pushing their adoption in our area over the next few years.
  • 3yr
    I think that current biosimilars do not offer a meaningful price differential compared to the originator product. Where cost is a major concern, Avastin is a better option. While I have not seen/heard of safety issues, I think we are all watching closely to be sure that the quality controls of these new products are up to par. We are seeing some payors require use of a biosimilar, and I expect this to continue/expand and this will be the major driving force pushing their adoption in our area over the next few years.
  • 3yr
    Newer agents will have to aeperate themselves from the older group. Several head-to-head studies are needed to draw clear distinctions between these agents. The big winner will be the patients and the practitioner group. Should not take long for these head-to-head Apple to Apple comparisons to be completed.
  • 3yr
    Hoping that as more agents emerge that the costs will improve availability to our patients. Closely monitoring the "real world" experience.
  • 3yr
    It is difficult to be very excited about the introduction of anti-VEGF biosimilars. In general, biosimilars do not offer any advantages over the efficacy, or durability, of the reference drugs that they seek to replace. So, at best, they may offer a cost benefit for patients.
    And, while it may be beneficial for patients to have this treatment option, it would be so much more meaningful if the biosimilar was an actual improvement over, rather than a substitute for, an already available drug.
  • 3yr
    I do not currently use biosimilars, current drugs are actually cheaper than biosimilars.
  • 3yr
    I used MVASI for a while when I didn't have access to compounded Avastin in 2020-2021. Personally, I saw no difference in efficacy or safety. Percentage wise, it was a good amount (20-25%) but considering Avastin is cheap per syringe, it wasn't that much of a savings boon.

    If efficacy/safety are the same, my main determinations for using it would be how much savings would it really offer vs using brand name and how much of a hassle it is to obtain biosimilars and get payers to pay for them. While expensive, I don't get much fuss over using Eylea and Vabysmo with most payers as long as the prior authorizations are sent same day.
  • 3yr
    Starting to use the biosimilar for some of our patients. Just as other anti-VEGF we have used, the more clinical experience we have with these new drugs, more likely we will use them as long as the safety and efficacy are the same compared to the branded products. I do believe the transition will be slow since most physicians are comfortable keeping patients on the same regimen if the patient is doing well.
  • 3yr
    Some cost savings to patient and insurance so likely will continue increase in biosimilar usage. Closely monitoring efficacy and side effect profile.
  • 3yr
    My experience is to learn much more about bio similars and be in the forefront of technology
  • 3yr
    Given Byooviz has been FDA approved, the studies that led to approval ensure it is not only equivalent in terms of clinical effectiveness to the reference product (Lucentis) but also that it has similar safety. Another point to keep in mind is companies such as Biogen have a track record of developing biosimilars in the oncology and rheumatology space, but are just starting to product ophthalmologic biosimilars. I agree it is important for the ophthalmology community to be vigilant with ophthalmology biosimilars in the real world since approval.
  • 3yr
    starting to see more of these agents and should help in overall cost and financial burden to some of our patients; will need to really vet to see efficacy and safety

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