Table A3.

Themes and statements (Delphi process stage 2).

Presence of multiple suppliers on an ongoing basis—although there is no “correct” number of suppliers	1.Biosimilars offer choice and are an important savings opportunity that can benefit the health care system broadly
Competition that is effective in reducing prices for biologics/biosimilars to a sustainable level	2.The presence of multiple suppliers offers benefits (with some trade-offs)
Shared decision making with payer, pharmacist, physician, and patients around biosimilar use	3.Competition offers benefits (with some trade-offs)
Reliable supply of biosimilars that meet appropriate standards for quality	4.Effective implementation is necessary for sustainability
Stability in procurement structure and approach	5.Excessive levels of competition have potential to be detrimental to the future of competition in biosimilars markets
Avoidance of price erosion that leads to market exit and the emergence of monopolies or the consolidation of suppliers	6.The level at which procurement happens has consequences for the number of manufacturers in the market—national versus sub-national