Biosimilar Savings Through 2025 Could Total $38.4 Billion


Savings from adalimumab biosimilars, which won't enter the US market until 2023, account for a significant share of the total, investigators said.

A team of researchers have concluded that savings from biosimilars from 2021 to 2025 could total $38.4 billion, if the downward pressure biosimilars exert on reference drug prices is included, and that savings could be higher if managed care and other clinical settings increase biosimilar use.

The study was published in The American Journal of Managed Care®, the sister publication of The Center for Biosimilars®.

“Although biosimilars have the potential to lower prices through competition, barriers to biosimilar uptake may limit these savings,” they cautioned. “Managed care organizations, payers, and policy makers have an interest in better understanding the potential for existing and future biosimilars to help control price and spending growth for biologics.”

Their assumptions for growth in biosimilar savings took into account the potential for biosimilar sales increases and market entry of new biosimilars. They assumed that $26.1 billion of estimated savings would come from new biosimilar products.

Adalimumab biosimilars are not projected to enter the US marketplace until 2023, but under the core savings projection, these biosimilars would account for $19.5 billion or a 50.8% share of savings from 2021-2025, authors of the study said.

They reasoned that $24.6 billion of estimated savings would result from the downward pressure on reference drug prices caused by biosimilar competition.

A more optimistic scenario for biosimilar growth and acceptance resulted in an estimate of $124.5 billion in potential savings during the 5-year period. This scenario “assumed greater biosimilar entry, volume shares, and price competition compared with assumptions used in the main approach.”

Biologics, made from living organisms, are among the most costly drugs, and although they accounted for just 2% of US prescriptions in 2017, they amounted to 37% of net spending on prescription drugs overall, which explains the value of biosimilar competition in lowering the amount of spending and improving affordability for patients.

There are currently 33 biosimilars approved for use in the United States, and of those, just two-thirds have been launched, or marketed, so far. These products are available mainly for treatment of cancer and cancer-related conditions. There are 7 approved adalimumab (Humira) biosimilars.

Investigators projected biologics spending based on 60 biologics including the 7 facing biosimilar competition as of the fourth quarter of 2020 (bevacizumab, epoetin, filgrastim, infliximab, pegfilgrastim, rituximab, and trastuzumab). These biologics accounted for $724.4 billion in sales from 2014 to 2020 at manufacturer list prices.

Managed care organizations, payers, and policy makers have an interest in better understanding the potential for existing and future biosimilars to help control price and spending growth for biologics.

Data for the study were drawn from medical research company IQVIA’s MIDAS database.

Under a constant spending scenario, in which biologics spending conditions remained the same over the 5-year period, using the fourth quarter of 2020 as the baseline, spending would be $648.0 billion from 2021 to 2025, the investigators wrote.

Spending over the 5 years that included the $38.4 billion in savings from expanded biosimilar competition would be $609.6 billion, they said. That represents more than 20% of estimated spending of $2.5 trillion for all prescription drugs over the 5-year span, they wrote.

Investigators said that the bulk of biosimilar savings (68.1% or $26.1 billion) under their main growth scenario would come from new biosimilars introduced from 2021 to 2025.

Also, savings from new biosimilar insulins, which started to become available at the close of 2021, would be $4.1 billion over the 5-year period, the authors wrote. “All other biologics without current biosimilar competition accounted for savings of $2.6 billion (6.7%).”

Although the authors did account for some downward pressure on reference drug prices, “this approach omits a significant share of savings resulting from lower reference biologic prices,” they wrote.

They said their savings estimates were “modest” compared with recent studies “that estimated savings of $69 billion to $140 billion from 2020 to 2024.”


Mulcahy A, Buttorff C, Finegold K, et al. Projected US Savings From Biosimilars, 2021-2025. Am J Manag Care. Published online January 3, 2021.

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