AHIP's New CEO Supports Reducing Drug Costs Through Robust Biosimilar Market

Insurance lobbying group, America’s Health Insurance Plans (AHIP), recently named Matt Eyles as its next president and CEO to take over for Marilyn Tavenner beginning June 1. Eyles, currently AHIP’s chief operating officer, recently gave a statement about his priorities for the organization once he begins his tenure.

“Looking ahead, it’s really addressing issues related to the affordability of healthcare and how we make it easier and simpler for consumers… we really want to see consumers have more affordable, lower premium options in 2019 that also provide comprehensive coverage,” said Eyles in a statement.

One way to tackle the affordability of healthcare and rising drug costs is through a robust biosimilars market, according to a blog post on AHIP’s website. Biologics and other specialty medications are the fastest growing component of prescription drug spending, rising between 11.3% and 17.7% in 2017 alone.

The post discusses 6 policy changes that would reduce drug prices and encourage biosimilar usage:

• The FDA can urge competition and innovation by finalizing regulations and guidance on important issues related to product labeling and interchangeability standards of biosimilars.
• Congress should consider shortening the exclusivity period for biologics from 12 to 7 years in order to promote greater price competition, as well as earlier access to biosimilars.
• Barriers should be removed at the state level that restrict the use and approval of biosimilars interchangeable with biologics. As interchangeability and substitution standards are finalized by the FDA, policy makers should avoid mandates that could restrict patient access to the medication.
• Congress should take steps to prohibit abuse and manipulation of the patent process in ways that prevent generics and biosimilars from entering the market in a timely manner.
• Congress should reform reimbursement for drugs covered by Medicare Part B to allow CMS flexibility to set a single payment rate for groups of clinically similar drugs based on the lowest cost item.
• Funding should be expanded for groups such as the Patient-Centered and Outcomes Research Institute (PCORI) to conduct research that incorporates cost information into studies that assess the comparative effectiveness of procedures, drugs, and medical devices.

“We’re focused on things that would get some real competition into the marketplace," said Eyles. "The first thing in the short-term is getting the CREATES Act enacted, which would end some of the gaming around access to drug samples that really can’t be justified by any stretch. The second area is focusing on biosimilars and realizing the potential of biosimilars to drive cost and price savings in the market."