More Biosimilars on the Market Could Decrease Drug Prices, Panelists Say

In a webcast hosted by the Alliance for Health Policy that took place earlier this week, Robert Langreth, senior health reporter for Bloomberg News, Dora Hughes, MD, MPH, senior policy advisor at Sidley Austin, LLP, and Sameer Awsare, MD, associate executive director of the Permanente Medical Group at Kaiser Permanente, came together to discuss the best ways to bring down the steadily increasing drug prices in the United States. The panel was moderated by Mary Ella Payne, RN, MSPH, president of the Alliance for Health Policy.

Langreth opened the discussion by providing background on how drug pricing functions in the United States, and the differences between brand-name drug pricing and generic drug pricing practices. Langreth pointed out that the list price of a drug does not include any rebates negotiated by the pharmacy benefit managers. Historically, however, these list prices have been increasing at alarming rates. He provided an example of reference adalimumab (Humira), which had a list price of $762 in 2009, and with added discounts, the price decreased to around $630. However, as of 2015, the list price rose 127% to $1728, with added discounts only bringing it down to $1331.

The main difference between pricing of brand-name or generic drugs is that, while brand name prices go up, on average, generic prices tend to go down. “[The pricing] of generics is of growing importance because 80% to 90% of prescriptions filled in the United States are generic,” said Langreth.

Building on the discussion, Hughes gave an overview of the “American Patient’s First” plan, jointly announced by President Trump and HHS Secretary Alex Azar in a press conference last month, and credited the FDA and its Commissioner, Scott Gottlieb, MD, “for leading the charge on addressing the high cost of drugs.” Gottlieb, she pointed out, has released a drug competition plan that includes multiple actions the FDA is taking to promote competition within the pharmaceutical industry. Included within this strategy is the forthcoming Biosimilar Innovation Plan, designed to promote the development and efficient review process of biosimilars.

Awsare added his thoughts on the issue of drug pricing, stating that “Drug pricing in our country is broken. The average drug price of a specialty drug now exceeds the median US household income. The system is not working.” Awsare sees the problem being alleviated in 3 ways: increased transparency, competition, and value.

Awsare also went on to discuss the value that biosimilars have in the market, and his experience with physicians using biosimilars at Kaiser Permanente. “When Zarxio came out, we had our physicians look at the data and compare the numbers between the biosimilar and the reference and immediately saw the value. I think we’ve been leading the nation with using biosimilars because we can get our physicians to look at the evidence and move their patients over to the product,” said Awsare.