Biosimilars Access: It's Time to Choose

In the face of a wave of bipartisan legislative momentum to reduce drug prices for consumers, it doesn't take political genius to see the benefits of joining the winning team. Major biopharmaceutical industry players have rushed to align their messaging with that of policymakers on questions of affordability, accessibility, and choice, cheering on the progress of biosimilars. Many are sincere in their support, but others are decidedly not. It's clear that biosimilars offer significant savings to patients who are given the freedom to choose the best value. The real question is, who will support giving patients that choice, and who will fight to rob them of it? It's time to make a choice, and those who oppose biosimilar access and patient choice are on the wrong side of history.

For example, in a recent op-ed, Amgen professed its belief that "head-to-head competition between biosimilars and originator biologics on a level playing field can generate meaningful savings." These words were published just 3 days before UnitedHealthcare, incentivized by Amgen, implemented a fail-first policy preferring Amgen's pegfilgrastim therapy, Neulasta, over 2 lower-cost biosimilars, reversing a formulary arrangement reached only months before to ensure coverage of pegfilgrastim biosimilars at parity. Since July 1, many UnitedHealthcare chemotherapy patients have not had access to Udenyca, the pegfilgrastim biosimilar sold by my company, Coherus BioSciences, at a 33% discount to Neulasta’s list price. Pressuring or incentivizing insurers to block access to lower-cost biosimilars does not produce a "level playing field," and it denies patients access to "meaningful savings" by design.

Amgen's biosimilars business unit has given it cover to pursue an aggressive antibiosimilars strategy to protect its valuable originator portfolio, including what Pfizer has challenged as misinformation, litigation, and what Coherus believes are anticompetitive, potentially multiproduct rebate agreements. Lawmakers should not be distracted with talk of a "level playing field"—Amgen only seeks the freedom to restrict patient choice and continue hiking prices with impunity, without government intervention that could encourage true competition. Today, it's UnitedHealthcare—insured cancer patients who are literally paying the price. Tomorrow, it will be patients reliant on other biologic products.

Biosimilars access is a pillar of Washington's efforts to control the unsustainable growth of drug prices, and estimates show that greater uptake will yield significant savings. A Pacific Research Institute study released this month estimates that, at just 25% market share, pegfilgrastim biosimilars like Udenyca would yield savings of over $100 million relative to current expenditures. Without head-to-head competition and full patient access to available options, biosimilars cannot generate the savings patients need, so there is no longer middle ground on the question of patient choice.

At Coherus, we've made our decision. We have only sought parity insurance coverage with originator biologics, giving doctors and patients the freedom to make the right decision for them, and that's a policy we'll continue. Many companies with originator portfolios, like Pfizer, have also chosen the principled path of prioritizing patient choice. In the height of its hypocrisy on biosimilars, Amgen truly stands alone.

The biosimilars market is still in a nascent stage, with only 23 biosimilars approved and only 9 available to US patients today (Amgen defends its originator franchise against 5). If originator manufacturers like Amgen are successful in blocking patient access to biosimilars, we will never see the extensive investment and development required to provide lower-cost options to the many biologics American patients count on. Biologic price increases will continue to vastly outpace inflation, and, more importantly, sick patients' ability to cover high co-payments and deductibles.

Manufacturers, providers, payers, and policymakers alike must decide whether patients deserve to choose the best-value option for them. Either we'll take the steps required to end anticompetitive rebate agreements and allow patients to access lower-cost biosimilars, or we'll watch as we slowly lose the most practical tool available to restrict and reverse biologic price increases. Voters demand progress, and Washington is ready. It's time for meaningful action to protect competition and patient choice.