Michael Kolodziej, MD: How Payers Are Preparing for Biosimilars

Michael Kolodziej, MD, vice president and chief innovation officer at ADVI Health, Inc, discusses how payers are planning for biosimilars.
January 03, 2019


Well, the way payers are going to approach biosimilars depends a little bit on the behavior of the reference product manufacturers.

Let’s say that the reference product manufacturers decide that they don’t really want to compete on price. In which case, I will predict that the commercial payers particularly—and that includes Medicare Advantage—will institute a policy similar to that around the use of generics. That is, they will require the use of the biosimilar first unless there’s a reason you can’t use a biosimilar.

But of course, in today’s world, we have the potential for manufacturers to undercut the price of the biosimilar product by offering a rebate. That is in fact already happening quite extensively in the inflammatory disease space; we will see what happens in the oncology space.


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