Is big pharma really designed to do biosimilars or are exits imminent?

Nusbickel: I really can't speak to how the other pharmas will approach biosimilars.

If you look at what Amgen has done so far, they've been very successful in this area; they've been able to rely on their track record of success and manufacturing and bringing forth products in key areas. Pfizer has also been very successful.

I think the challenge will be when you look at policies that potentially could incentivize more biosimilar adoption. The large pharma companies in those areas tend to be more conservative and look to endorsing policies that protect their bigger brands and business.

That's why when you look at a company like Celltrion, right now most of our revenue will continue to be driven this decade by biosimilar growth in the US and then by some of the improved formulations of existing biosimilars. So I think we'll be able to really be focused and deliberate in supporting the biosimilar market.

The jury's still out on the other large pharma players - certainly they will need to look at their business over time to see if they'll stay in the game as it changes. If you posit on the pharmacy benefit products, if it becomes much more of a payer-driven kind of situation, then obviously, I think big pharma will look at their economics and decide whether they're going to play.

But even in the last decade, when I looked at kind of how much of the revenue from a product now goes into the distribution chain, the wholesalers and PBMs, it's increased pretty dramatically from when I started my career. So big pharma are already feeling kind of the pinch that everyone faces from the overall distribution chain that we see with the increased power of the payer in regards to the full chain in pharmaceuticals.

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