Table 3.

Consensus on drivers and risks to biosimilar market sustainability (procurement processes).

I.  Procurement processes should avoid monopolies and minimize patient and health care system disruption
The emergence of monopolies may lead to higher price levels and/or enhanced supply risks
There are examples of this in generics, although these issues would be more pronounced for biosimilars due to lengthy development and market entry processes
Procurement design should aim to:
Prevent predatory behaviour, e.g., by considering factors other than price to avoid aggressive price discounting
Minimize disruption of patient care, based on the needs of individual therapeutic areas, e.g., by setting contract duration that is proportional to duration of treatment
II.  The principles for procurement should be agreed by all stakeholders
There should be a multistakeholder group that sets principles for policy and practice around biosimilar procurement
Patients and physicians should have an opportunity for their views to be represented (e.g., in a national forum) and patients should be informed of the rationale behind procurement decisions that impact on their care
There can be no one-size-fits-all approach to procurement, as the structure and characteristics of health care systems vary; however, there should be a consistent approach and a common set of guiding principles

Note: icons shown on the right represent level of agreement between the stakeholders. The ‘consensus’ icon indicates that all stakeholders (physicians, payers, policy advisors, manufacturers, pharmacists, and patients) agreed on that point.