A new report from Matrix Global Advisors and the National Business Group on Health, sponsored by Boehringer Ingelheim, shows that employers could see substantial savings from biosimilars, but those savings won’t come without a concerted effort to encourage biosimilar use.
A new report from Matrix Global Advisors and the National Business Group on Health, sponsored by Boehringer Ingelheim, shows that employers could see substantial savings from biosimilars, but those savings won’t come without a concerted effort to encourage biosimilar use.
The report uses real-world claims data provided by a large manufacturing company with a high-deductible plan covering more than 80,000 members. It offers a base-case, an optimistic-case, and a best-case scenario for biosimilar savings depending on varying levels of utilization and price discounts for biosimilars of the 17 biologics in the medical benefit that face or are likely to face biosimilar competition.
The employer’s data show that, in 2017, 392 patients used these 17 biologics. Some of these biologics have currently available biosimilars (trastuzumab, bevacizumab, epoetin alfa, pegfilgrastim, filgrastim, and infliximab all have biosimilars launched in the United States), and others are expected to have biosimilar competitors in the near future (biosimilars of ranibizumab, aflibercept, and eculizumab, for example are under development by multiple drug makers) or in the coming years as patents expire.
The report presents 3 possible cases:
The report’s authors note, however, that “the mere existence of biosimilars in the US marketplace does not guarantee robust competition or the savings that follow.” They emphasize that employers who hope to capture substantial biosimilar savings will need to encourage biosimilar use through plan design, as well as through incentives and education for both providers and plan members.
The report proposes that savings from biosimilar use could be shared with members, and that plans could incentivize physicians to use biosimilars in appropriate contexts, for example.
In a statement on the report, Juliana Reed, president of the Biosimilars Forum, said that “Multi-stakeholder engagement—from Congress and the White House to physicians and payers—is crucial to overcoming barriers that inhibit [the] US biosimilars market from taking hold. Given their unique positioning to negotiate health plan designs with providers, employers are integral to this effort. This new analysis confirms that employers can also help patients and the health care system realize the savings potential of biosimilars, if they actively invest in promoting biosimilars utilization.”
HHS Praises Biosimilars Savings but Opportunities to Reduce Part B Spending Remain
November 28th 2023Although biosimilars have already generated savings for Medicare Part B programs and beneficiaries, opportunities for substantial reductions in spending remain, according to a report from the HHS.
Biosimilar Business Roundup for October 2023—Podcast Edition
November 5th 2023On this episode, we discuss the biggest news to come out of October 2023, including 3 regulatory approvals, 2 complete response letters, and new data and industry insights that have the potential to impact the entire US biosimilar industry.
Eye on Pharma: Adalimumab Updates; New Eylea Biosimilar Lawsuit; Canada Gains Stelara Biosimilar
November 22nd 2023Several companies make moves to further their adalimumab biosimilars, Regeneron sues Celltrion over biosimilar for Eylea (aflibercept), and Health Canada grants marketing authorization for biosimilar referencing Stelara (ustekinumab).
Biosimilars Business Roundup For August 2023—Podcast Edition
September 5th 2023On this episode, we’re giving an overview of some of the biggest stories in the business space regarding biosimilars, like the approval of the first neurology biosimilar, growth projections from company quarterly expense reports, and some analyses about the health of the market.
AMCP Nexus: Panelists Share Current Scope of Biosimilar Industry
October 26th 2023Panelists at the Academy of Managed Care Pharmacy (AMCP) Nexus meeting chronicled the current state of the US biosimilar market, including current policies impacting the market, recent regulatory decisions, and the developing arguments around requirements for clinical efficacy studies.
Report: Conflicting Guidelines, Rebate Walls Are Major Factors Determining Biosimilar Uptake
October 24th 2023Samsung Bioepis’ most recent biosimilar market report identified inconsistent medical guidelines, challenges with access and rebates, and acute vs chronic treatment duration as major factors influencing biosimilar uptake in the United States.