Introducing the AGA Biosimilars Advisory Panel
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Make informed treatment decisions about biosimilars

In recent years federal laws have been enacted to help provide more treatment options and possibly lower costs to patients for therapeutic biological products. You have likely heard or read about “biosimilars” on the U.S. drug market. But are you ready to make informed treatment decisions and answer patients’ questions about these new drugs?

Biosimilars are not “generic biologics.” Although the shared goal of making biosimilars and generic drugs available is to provide more treatment options, there are important differences between the two approval pathways. For instance, unlike generic drugs, which are “bioequivalent” to their reference listed drug, biosimilar products can be either “biosimilar” to or “interchangeable” with their reference product. The differences may seem subtle based on the terminology, but the differences are important, and health care professionals who prescribe, dispense, or administer these products will need to understand them – as well as other aspects of these new therapies.

To help busy health care professionals better understand biosimilar and interchangeable products, the FDA has created a free 1.5-hour continuing education program titled, FDA Overview of Biosimilar Products. The course describes the important characteristics of biological products, particularly their complexity. For instance, a single molecule of a biological product, such as a monoclonal antibody, can easily be many hundreds of times larger and much more complex than that of a “small molecule” drug such as aspirin. Their increased complexity is one reason they are regulated differently than generics – and why, in the case of biosimilars, the law allows some differences from the reference product in clinically inactive components. The CE course discusses the “inherent variability” in the production of all biological products – both reference and biosimilar – and how the FDA accounts for these differences in assessing safety and efficacy of the products. The course also provides detailed definitions of important terms – such as “biosimilar” and “interchangeable” – and an overview of the standards the FDA has established for reviewing and approving biosimilar and interchangeable products. It also outlines the FDA review and approval standards for biosimilars and interchangeable products to help practitioners be assured that these products have been demonstrated to be safe and effective treatment options for their patients.

Some of our most important and expensive drugs are biological products used to treat patients who have serious medical conditions that are often life threatening and usually life altering. In April 2016, the Food and Drug Administration approved Inflectra (infliximab-dyyb) to help treat certain patients with certain gastrointestinal disorders, such as Crohn’s disease, and for other indications such as treatment of psoriasis and rheumatoid arthritis. The product is approved but not yet marketed in the United States. However, last year, Zarxio (filgrastim-sndz) became the first biosimilar actually available in the U.S. marketplace – approved to help boost white blood cell production for patients with severe neutropenia as well as for patients receiving various cancer therapies. These products are “biosimilar” to already-approved biological products called “reference products.” Inflectra is biosimilar to the reference product, Remicade (infliximab), and Zarxio is biosimilar to Neupogen (filgrastim).

Use of safe and effective biosimilar and interchangeable biological products can potentially make treatment more affordable for patients in need and improve public health. As patients begin to ask about the use of biosimilar and interchangeable products, the FDA hopes this course will help prepare health care practitioners to make informed decisions on behalf of their patients.

Dr. Christl is Associate Director for Therapeutic Biologics at the Office of New Drugs, Center for Drug Evaluation and Research, FDA.

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The Food and Drug Administration’s recent approval of Inflectra (infliximab-dyyb) signals the advent of new therapeutic options in the treatment of patients with digestive diseases. However, there is still much to learn about biosimilars, their safety, and their efficacy. In the absence of sufficient clinical data, the American Gastroenterological Association has deferred taking a position on biosimilars. However, we recognize a critical need to educate gastroenterologists and their patients on this issue based on the information we have to date.

Dr. Gary R. Lichtenstein

In April 2016, the AGA Biosimilars Advisory Panel was created to determine key knowledge gaps regarding biosimilars, anticipate emerging issues around which to prepare AGA members, and recommend educational activities that address these gaps and issues. Upon review and approval by the AGA Institute Governing Board, the panel’s recommendations will be implemented by the AGA Center for Diagnostics and Therapeutics (CDT) in conjunction with other AGA committees. I am honored to chair this panel and look forward to working with my esteemed colleagues, all of whom are thought leaders in the field:

• Jean-Frederic Colombel, M.D., Mount Sinai Hospital

• Stephen B. Hanauer, M.D., AGAF, Northwestern University

• Sunanda V. Kane, M.D., MSPH, AGAF, Mayo Clinic

• Garrett Lawlor, M.D., Columbia University Medical Center

• James D. Lewis, M.D., MSCE, AGAF, University of Pennsylvania

• Loren A. Laine, M.D., AGAF, Yale University (CDT scientific advisory board liaison)

We hope to develop our initial recommendations in the next few months, recognizing that the field will continue to evolve quickly. AGA will also continue to work with the FDA and industry to ensure that the concerns of gastroenterologists are appropriately communicated and ensure that all of us are working together to improve the lives of patients with digestive diseases.

Dr. Gary R. Lichtenstein, AGAF, is chair, AGA Biosimilars Advisory Panel, and professor of medicine, Hospital of the University of Pennsylvania, Philadelphia.

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The Food and Drug Administration’s recent approval of Inflectra (infliximab-dyyb) signals the advent of new therapeutic options in the treatment of patients with digestive diseases. However, there is still much to learn about biosimilars, their safety, and their efficacy. In the absence of sufficient clinical data, the American Gastroenterological Association has deferred taking a position on biosimilars. However, we recognize a critical need to educate gastroenterologists and their patients on this issue based on the information we have to date.

Dr. Gary R. Lichtenstein

In April 2016, the AGA Biosimilars Advisory Panel was created to determine key knowledge gaps regarding biosimilars, anticipate emerging issues around which to prepare AGA members, and recommend educational activities that address these gaps and issues. Upon review and approval by the AGA Institute Governing Board, the panel’s recommendations will be implemented by the AGA Center for Diagnostics and Therapeutics (CDT) in conjunction with other AGA committees. I am honored to chair this panel and look forward to working with my esteemed colleagues, all of whom are thought leaders in the field:

• Jean-Frederic Colombel, M.D., Mount Sinai Hospital

• Stephen B. Hanauer, M.D., AGAF, Northwestern University

• Sunanda V. Kane, M.D., MSPH, AGAF, Mayo Clinic

• Garrett Lawlor, M.D., Columbia University Medical Center

• James D. Lewis, M.D., MSCE, AGAF, University of Pennsylvania

• Loren A. Laine, M.D., AGAF, Yale University (CDT scientific advisory board liaison)

We hope to develop our initial recommendations in the next few months, recognizing that the field will continue to evolve quickly. AGA will also continue to work with the FDA and industry to ensure that the concerns of gastroenterologists are appropriately communicated and ensure that all of us are working together to improve the lives of patients with digestive diseases.

Dr. Gary R. Lichtenstein, AGAF, is chair, AGA Biosimilars Advisory Panel, and professor of medicine, Hospital of the University of Pennsylvania, Philadelphia.

Body

The Food and Drug Administration’s recent approval of Inflectra (infliximab-dyyb) signals the advent of new therapeutic options in the treatment of patients with digestive diseases. However, there is still much to learn about biosimilars, their safety, and their efficacy. In the absence of sufficient clinical data, the American Gastroenterological Association has deferred taking a position on biosimilars. However, we recognize a critical need to educate gastroenterologists and their patients on this issue based on the information we have to date.

Dr. Gary R. Lichtenstein

In April 2016, the AGA Biosimilars Advisory Panel was created to determine key knowledge gaps regarding biosimilars, anticipate emerging issues around which to prepare AGA members, and recommend educational activities that address these gaps and issues. Upon review and approval by the AGA Institute Governing Board, the panel’s recommendations will be implemented by the AGA Center for Diagnostics and Therapeutics (CDT) in conjunction with other AGA committees. I am honored to chair this panel and look forward to working with my esteemed colleagues, all of whom are thought leaders in the field:

• Jean-Frederic Colombel, M.D., Mount Sinai Hospital

• Stephen B. Hanauer, M.D., AGAF, Northwestern University

• Sunanda V. Kane, M.D., MSPH, AGAF, Mayo Clinic

• Garrett Lawlor, M.D., Columbia University Medical Center

• James D. Lewis, M.D., MSCE, AGAF, University of Pennsylvania

• Loren A. Laine, M.D., AGAF, Yale University (CDT scientific advisory board liaison)

We hope to develop our initial recommendations in the next few months, recognizing that the field will continue to evolve quickly. AGA will also continue to work with the FDA and industry to ensure that the concerns of gastroenterologists are appropriately communicated and ensure that all of us are working together to improve the lives of patients with digestive diseases.

Dr. Gary R. Lichtenstein, AGAF, is chair, AGA Biosimilars Advisory Panel, and professor of medicine, Hospital of the University of Pennsylvania, Philadelphia.

Title
Introducing the AGA Biosimilars Advisory Panel
Introducing the AGA Biosimilars Advisory Panel

In recent years federal laws have been enacted to help provide more treatment options and possibly lower costs to patients for therapeutic biological products. You have likely heard or read about “biosimilars” on the U.S. drug market. But are you ready to make informed treatment decisions and answer patients’ questions about these new drugs?

Biosimilars are not “generic biologics.” Although the shared goal of making biosimilars and generic drugs available is to provide more treatment options, there are important differences between the two approval pathways. For instance, unlike generic drugs, which are “bioequivalent” to their reference listed drug, biosimilar products can be either “biosimilar” to or “interchangeable” with their reference product. The differences may seem subtle based on the terminology, but the differences are important, and health care professionals who prescribe, dispense, or administer these products will need to understand them – as well as other aspects of these new therapies.

To help busy health care professionals better understand biosimilar and interchangeable products, the FDA has created a free 1.5-hour continuing education program titled, FDA Overview of Biosimilar Products. The course describes the important characteristics of biological products, particularly their complexity. For instance, a single molecule of a biological product, such as a monoclonal antibody, can easily be many hundreds of times larger and much more complex than that of a “small molecule” drug such as aspirin. Their increased complexity is one reason they are regulated differently than generics – and why, in the case of biosimilars, the law allows some differences from the reference product in clinically inactive components. The CE course discusses the “inherent variability” in the production of all biological products – both reference and biosimilar – and how the FDA accounts for these differences in assessing safety and efficacy of the products. The course also provides detailed definitions of important terms – such as “biosimilar” and “interchangeable” – and an overview of the standards the FDA has established for reviewing and approving biosimilar and interchangeable products. It also outlines the FDA review and approval standards for biosimilars and interchangeable products to help practitioners be assured that these products have been demonstrated to be safe and effective treatment options for their patients.

Some of our most important and expensive drugs are biological products used to treat patients who have serious medical conditions that are often life threatening and usually life altering. In April 2016, the Food and Drug Administration approved Inflectra (infliximab-dyyb) to help treat certain patients with certain gastrointestinal disorders, such as Crohn’s disease, and for other indications such as treatment of psoriasis and rheumatoid arthritis. The product is approved but not yet marketed in the United States. However, last year, Zarxio (filgrastim-sndz) became the first biosimilar actually available in the U.S. marketplace – approved to help boost white blood cell production for patients with severe neutropenia as well as for patients receiving various cancer therapies. These products are “biosimilar” to already-approved biological products called “reference products.” Inflectra is biosimilar to the reference product, Remicade (infliximab), and Zarxio is biosimilar to Neupogen (filgrastim).

Use of safe and effective biosimilar and interchangeable biological products can potentially make treatment more affordable for patients in need and improve public health. As patients begin to ask about the use of biosimilar and interchangeable products, the FDA hopes this course will help prepare health care practitioners to make informed decisions on behalf of their patients.

Dr. Christl is Associate Director for Therapeutic Biologics at the Office of New Drugs, Center for Drug Evaluation and Research, FDA.

In recent years federal laws have been enacted to help provide more treatment options and possibly lower costs to patients for therapeutic biological products. You have likely heard or read about “biosimilars” on the U.S. drug market. But are you ready to make informed treatment decisions and answer patients’ questions about these new drugs?

Biosimilars are not “generic biologics.” Although the shared goal of making biosimilars and generic drugs available is to provide more treatment options, there are important differences between the two approval pathways. For instance, unlike generic drugs, which are “bioequivalent” to their reference listed drug, biosimilar products can be either “biosimilar” to or “interchangeable” with their reference product. The differences may seem subtle based on the terminology, but the differences are important, and health care professionals who prescribe, dispense, or administer these products will need to understand them – as well as other aspects of these new therapies.

To help busy health care professionals better understand biosimilar and interchangeable products, the FDA has created a free 1.5-hour continuing education program titled, FDA Overview of Biosimilar Products. The course describes the important characteristics of biological products, particularly their complexity. For instance, a single molecule of a biological product, such as a monoclonal antibody, can easily be many hundreds of times larger and much more complex than that of a “small molecule” drug such as aspirin. Their increased complexity is one reason they are regulated differently than generics – and why, in the case of biosimilars, the law allows some differences from the reference product in clinically inactive components. The CE course discusses the “inherent variability” in the production of all biological products – both reference and biosimilar – and how the FDA accounts for these differences in assessing safety and efficacy of the products. The course also provides detailed definitions of important terms – such as “biosimilar” and “interchangeable” – and an overview of the standards the FDA has established for reviewing and approving biosimilar and interchangeable products. It also outlines the FDA review and approval standards for biosimilars and interchangeable products to help practitioners be assured that these products have been demonstrated to be safe and effective treatment options for their patients.

Some of our most important and expensive drugs are biological products used to treat patients who have serious medical conditions that are often life threatening and usually life altering. In April 2016, the Food and Drug Administration approved Inflectra (infliximab-dyyb) to help treat certain patients with certain gastrointestinal disorders, such as Crohn’s disease, and for other indications such as treatment of psoriasis and rheumatoid arthritis. The product is approved but not yet marketed in the United States. However, last year, Zarxio (filgrastim-sndz) became the first biosimilar actually available in the U.S. marketplace – approved to help boost white blood cell production for patients with severe neutropenia as well as for patients receiving various cancer therapies. These products are “biosimilar” to already-approved biological products called “reference products.” Inflectra is biosimilar to the reference product, Remicade (infliximab), and Zarxio is biosimilar to Neupogen (filgrastim).

Use of safe and effective biosimilar and interchangeable biological products can potentially make treatment more affordable for patients in need and improve public health. As patients begin to ask about the use of biosimilar and interchangeable products, the FDA hopes this course will help prepare health care practitioners to make informed decisions on behalf of their patients.

Dr. Christl is Associate Director for Therapeutic Biologics at the Office of New Drugs, Center for Drug Evaluation and Research, FDA.

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