For years, biosimilars have been promoted as a way to lower costs and expand access to biologic therapies. But in practice, adoption has often lagged behind expectations. Securing payer coverage alone has not been enough to shift prescribing behavior or meaningfully reduce healthcare spending. Driving adoption requires coordination across multiple parts of the healthcare system.

“We’ve realized that just getting payer coverage is not—that only gets you so far,” said Louis Savant, Senior Director, U.S. Value & Access Strategy at Teva Pharmaceuticals. “You have to make sure that you are working with all the other stakeholders in the ecosystem.”

That realization has shaped a broader strategy—one that goes beyond formulary placement and focuses on coordinated action across payers, providers, pharmacies, and health systems. The approach has delivered measurable results, including strong market positioning for multiple biosimilars in highly competitive categories.

A Holistic Ecosystem Approach

At the core of this success is what Savant describes as a “more holistic ecosystem approach.”

Rather than focusing narrowly on payer contracts, the strategy recognizes that adoption is influenced by a wide range of decision-makers—from physicians and pharmacists to distributors and specialty pharmacies.

“It really does take everybody to ensure that a biosimilar is successful,” Savant said. “They all have the ability to help with your access and adoption, or they can inhibit it.”

This broader lens reflects the complexity of modern healthcare, where fragmented incentives and operational barriers can slow even the most cost-effective therapies.

Contracts That Drive Behavior

Equally important has been a shift in how contracts are structured—not just to secure access, but to actively encourage biosimilar use.

“We’ve written contracts in ways that encourage behaviors and strategies that help to drive adoption,” Savant said.

One of the most effective tactics has been creating meaningful differentiation between biosimilars and their reference products.

“You have to disadvantage the innovator or reference product,” he explained. “If you don’t disadvantage the innovator product, you know that biosimilar uptick is going to be slow.”

That “disadvantage” is not symbolic—it must be operational. Preferred formulary status alone is not enough. Instead, successful plans have implemented step therapy requirements, adjusted patient cost-sharing, and reduced administrative barriers for biosimilars.

“It has to have something that has some teeth in it,” Savant said.

Among the most impactful changes has been simplifying or eliminating prior authorization requirements for biosimilars, while maintaining stricter requirements for higher-cost branded biologics.

“Anything that the payer can do to lessen the burden on the provider makes a big difference,” he noted.

Reducing Friction for Providers and Patients

Provider behavior plays a critical role in adoption, particularly when administrative burdens influence treatment decisions.

In one case, physicians were opting to switch patients to entirely different branded biologics rather than biosimilars—not because of clinical advantages, but because of workflow challenges, Savant said.

“If I’m going to have to do a prior authorization anyway, I might as well just move the patient over to a new product,” providers told the health plan.

That insight proved pivotal. By removing prior authorization requirements for biosimilars—while keeping them in place for alternative branded therapies—plans were able to redirect prescribing patterns.

“They waived the prior auth if they just switched to the biosimilar,” Savant said. “So now if they want to go to Skyrizi or Rinvoq, they have to do a prior auth. They don’t have to do a prior auth for the biosimilar.”

At the same time, aligning financial incentives for both patients and providers has been critical. Lower out-of-pocket costs, improved reimbursement structures, and accessible copay assistance programs all contribute to making biosimilars the easier choice.

Communication as a Strategic Lever

Even with the right policies in place, adoption depends on clear and consistent communication.

Plans that have seen the greatest success have invested in targeted outreach to both providers and patients—explaining not only the cost savings, but also the clinical equivalence and practical benefits of biosimilars.

“They clearly articulate what the benefits are, and they make sure that the benefits don’t look like it’s just benefits for the payer,” Savant said.

This includes proactive engagement with high-volume prescribers and ensuring that operational details—such as product availability and prior authorization criteria—are well understood.

Rapid Market Share Shifts Are Possible

When these strategies are aligned, the results can be dramatic.

In one example, a health plan that had struggled to move patients off a reference biologic—maintaining more than 90% market share for the branded product even years after biosimilar entry—was able to rapidly reverse course.

After implementing a combination of step therapy, reduced administrative burden, and targeted communication, the shift was swift.

“In less than 90 days—well less than 90 days, probably around 75 days—it took them to move from less than 10% market share to over 90% market share of our biosimilar product,” Savant said.

That rapid adoption is critical, not only for reducing costs but also for realizing the financial benefits that justify biosimilar use in the first place.

“They have to drive biosimilar adoption, and they have to be able to drive it relatively quickly,” he said. “That’s the key to driving the savings.”

A Shift Away from Rebates

Underlying these changes is a broader shift in how payers and pharmacy benefit managers (PBMs) evaluate value.

Historically, high list prices paired with large rebates dominated contracting strategies. But growing scrutiny around pricing transparency is changing that dynamic.

“We may have turned a corner where, at least in our engagement with PBMs and payers, they’re really focused on lowering the net cost for their members,” Savant said.

As a result, success in the biosimilar market increasingly depends not just on pricing, but on the ability to deliver sustained adoption.

“Do you have the know-how to drive adoption? That’s the key,” Savant said.

The Bottom Line

As biosimilars continue to expand across therapeutic areas, it is becoming increasingly clear that access alone does not guarantee uptake.  Instead, success depends on aligning incentives, reducing friction, and coordinating across the healthcare ecosystem to make biosimilars the most practical and attractive option.

“At the end of the day,” Savant said, “if you employ the right strategies and take this holistic approach so that everybody in the ecosystem is aligned on it, you can move market share very quickly with biosimilars.”

And in a system under increasing pressure to control costs, that ability may prove to be the most valuable asset of all.