CMS Dashboards Show Rising Costs for Drugs Targeted by Biosimilar Competition

CMS has released updated versions of its online Drug Spending Dashboards, which are intended to help consumers, researchers, policy makers, and other stakeholders understand how spending on prescription drugs per dosage is changing over time.

This update of the dashboards includes year-over-year spending changes for individual drugs and highlights the drugs prescribed most under Medicare and Medicaid. Data from the dashboards reveal that many of the drugs that have seen the highest annual growth in spending per beneficiary over the 2012 to 2016 period are products that either currently face or will soon face biosimilar or follow-on biologic competition.

Under Medicare Part B, which covers drugs that are generally administered by healthcare providers rather than by patients themselves, spending on innovator infliximab (Remicade) grew by 6.0%, with average monthly per beneficiary spending reaching $1910. Two biosimilars (Renflexis and Inflectra), both of which launched at discounts to Remicade, are FDA approved and currently available.

Spending on innovator rituximab (Rituxan), for which multiple companies are developing biosimilars, grew by 5.6%, with average monthly spending reaching $1985. Spending on pegfilgrastim (Neulasta), which is also targeted by biosimilar developers, grew by 8.5%, with average spending of $1195.

Under Medicare Part D, which generally covers self-administered drugs, several products that have approved (but unlaunched) biosimilars or approved follow-ons were among the products that also saw significant increases in pricing. Spending on adalimumab (in the Humira pen presentation) rose by 18.0% to $2835 per month. Currently, 2 adalimumab biosimilars are approved by the FDA, but neither is expected to launch prior to 2023. Spending on Etanercept (Enbrel) rose by 18.2% to $2741. One etanercept biosimilar has gained the FDA’s approval, but no launch date has been announced, as patents concerning the reference etanercept continue to be the subject of ongoing litigation, a trial for which is slated to begin in September 2018.

The 2 presentations of insulin glargine (Lantus and Lantus Solostar) rose by 18.3% to $209 and 14.2% to $196, respectively. Basaglar, a follow-on insulin glargine, is FDA approved and commercially available, and Lusduna, another follow-on, has been tentatively approved pending the conclusion of patent litigation.

Spending on many of the same drugs increased under Medicaid as well; spending on Humira rose by 17.5%, on Enbrel by 17.6%, on Lantus by 18.7%, and on Lantus Solostar by 14.3% under Medicaid.

In a statement concerning the new dashboards, CMS Administrator Seema Verma said that “Publishing how much individual drugs cost from one year to the next will provide much-needed clarity and will empower patients and doctors with the information they need. As [HHS] Secretary Azar has repeatedly pointed out, for years Medicare incentives have actually encouraged higher list prices for drugs, and this updated and enhanced dashboard is an important step to bringing transparency and accountability to what has been a largely hidden process.”