CVS Health Survey Finds Patients Ready for Cost-Saving Biosimilars

Pharmacy Benefit Manager (PBM) CVS Health, which has over 90 million members, has released the results of a survey it conducted of approximately 2000 people in the United States concerning patient perceptions of generic and biosimilar medications.

Of the respondents, 60% reported taking prescription drugs. Among that group:

• 72% reported that they paid less than $50 each month for their medications, and 85% reported paying less than $100 each month
• 58% reported taking more than 3 prescriptions

Overall, the survey demonstrated acceptance of generic drugs:

• 68% report taking at least 1 generic
• 85% reported spending less money, while receiving the same effects, by switching to a generic
• 80% said that they would accept a generic if it would reduce their out-of-pocket spending

Some respondents also saw the potential to benefit from biosimilar medications:

• 60% reported that they would accept a biosimilar in place of a branded biologic if it would provide them with a cost savings

CVS Health notes that, in 2016, clients who used the company’s generics-focused formulary saw an 88.2% increase in the rate of dispensed generics (3.2% higher than the rate for clients using the PBM’s standard formulary). The PBM expects to generate $13.4 billion in savings for its clients over the 2012 to 2018 period through including more low-cost drugs on its formularies, encouraging patients to switch to available generics, and including biosimilars in its formulary strategy.

The PBM says that specialty pharmaceuticals, including biologics, are responsible for approximately 36% of its total spending, and cited RAND Corporations projection that biosimilars in the specialty marketplace could reduce spending on biologics by $44.2 billion over the coming 10 years. Last year, CVS Health indicated its intention to move toward greater biosimilar use to reap some of those savings: its 2017 formulary employed biosimilar filgrastim (Zarxio) as a replacement for its reference (Neupogen). It also replaced reference insulin glargines (Lantus and Toujeo) with a follow-on (Basaglar). In its 2018 formulary, the PBM stopped short of including the newly launched biosimilar infliximab (Renflexis), but noted that “The autoimmune class is a leading trend driver for commercial clients,” and said that it will evaluate its formulary in light of new product entries.

The American Medical Association (AMA) responded to CVS Health’s shift toward biosimilars last year with a call for patient and practitioner choice: AMA president Andrew Gurman, MD, said that “Patients should have the opportunity to choose from a wide range of available therapies. Certainly, biosimilars show great promise, but ultimately, it is important that the patient and his or her physician maintain the ability to choose the best therapy for that particular patient and situation.”