Looking Ahead to Cardinal Health's Biosimilar Pipeline

PC: In terms of the approval pipeline, what is coming down the pike?

Gregory: As far as biosimilars go in the pipeline, we’re pretty far into it. They’re not new anymore, but I feel like there's still this big boom happening right now with the adalimumab biosimilars. I previously mentioned adalimumab was very much influenced by payer PBM formulary changes. So, it’s just now finally taking after being on the market for over a year. It’s not necessarily a pipeline thing, but certainly a market share shift thing that I expect to see over the next year, year and a half in the adalimumab space. We saw a very slow initiation of adalimumab biosimilars just starting in April with a significant PBM shifting their formulary selections on adalimumab. We saw a 15% increase in market share month over month in that space. It really goes to show I think we'll see more of that. We're hearing other payer, PBMs, maybe making a big splash in that space as well. I do think that we'll see a little bit more pressure from the public and the legislative space on how PBMs view biosimilars and the placement of biosimilars on their formulary.

The basic pipeline of the products themselves, it is truly starting to take off. It’s exciting because some of the products that I was extremely concerned about 10 years ago from a spend perspective and an economic perspective are now seen in the pipeline as biosimilars. If we look at the near term, the next year in the immunology space remains hot, and that is a huge population of patients that need these types of medications. Stelara and Simponi are two medications in that immunology space that we expect to see coming to market as biosimilars, with ILEA in the retina space.

Some people don’t realize how much our healthcare system spends on retina biologics, so that's a significant opportunity for savings. Prolia and Xgeva are actually the same molecular compound, but they're for two different indications, oncology and bone health. We expect those to come to market over the next year or two.

Finally, in the multiple sclerosis space, where we don't have any biosimilars yet, Tysabri, so that's exciting as well.

Increasing in indications almost weekly are the PD1 inhibitors Optibo and Keytruda. Manufacturers have finally revealed that they have biosimilars for these in the pipelines, which I think is very exciting as well. I don't mean to leave anyone out, but those are some of the main ones that I've kind of got my eye on right now.