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.”
Skyrizi Overtakes Humira: “Product Hopping” Leaves Biosimilar Market in Limbo
November 7th 2024For the first time, Skyrizi (risankizumab-rzaa) has replaced Humira (reference adalimumab) as AbbVie’s sales driver, largely due to companies encouraging “product hopping” to avoid competition, creating concerns for the sustainability of the burgeoning adalimumab biosimilar market.
Biosimilars in America: Overcoming Barriers and Maximizing Impact
July 21st 2024Join us as we explore the complexities of the US biosimilars market, discussing legislative influences, payer and provider adoption factors, and strategies to overcome industry challenges with expert insights from Kyle Noonan, PharmD, MS, value & access strategy manager at Cencora.
Exploring the Biosimilar Horizon: Julie Reed's Predictions for 2024
February 18th 2024On this episode of Not So Different, Julie Reed, executive director of the Biosimilars Forum, returns to discuss her predictions for the biosimilar industry for 2024 and beyond as well as the impact that the Forum's 4 new members will have on the organization's mission.
Enhancing Adoption of Infused Biosimilars for a Sustainable Future
October 30th 2024An IQVIA report highlights challenges to the sustainability of infused biosimilars in the US, citing rebate walls and reimbursement policies, and proposes key solutions to enhance adoption and benefits for all stakeholders.