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Implementing and Optimizing Biosimilar Use at Mayo Clinic



      To determine whether the formation of a multidisciplinary team, pharmacist-led therapeutic interchange, and streamlined electronic health record optimization improved biosimilar adoption throughout Mayo Clinic.

      Patients and Methods

      The project focused on the use of reference products and biosimilars for 5 biologics—bevacizumab, epoetin alfa, filgrastim, rituximab, and trastuzumab—at all Mayo Clinic locations. Pharmaceutical wholesale purchase histories of those reference products and biosimilars were assessed from September 1, 2020, through August 31, 2021, and compared with data from September 1, 2019, through August 31, 2020. Formulary decisions were implemented across 5 biologics for most ordering pathways on September 1, 2020. Pharmaceutical purchased drug units and expenditures were tracked at 3-month intervals for conversion to formulary-preferred contracted biosimilars.


      In the final postimplementation period, the absolute percentage increase of formulary-preferred biosimilars was 69% for bevacizumab, 63% for epoetin alfa, 80% for filgrastim, 79% for rituximab, and 72% for trastuzumab. Pharmaceutical line item savings in the 12-month postimplementation period totaled $23.1 million across all 5 biologics.


      Creation of a multidisciplinary team to implement formulary-preferred contracted biosimilars led to the adoption of biosimilars throughout Mayo Clinic with considerable pharmaceutical line item savings.

      Abbreviations and Acronyms:

      EHR (electronic health record), EU (European Union), FDA (US Food and Drug Administration), MCPFS (Mayo Clinic Pharmaceutical Formulary Subcommittee), SCM (supply chain management)
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