New Bills on Biosimilars Access Are Introduced in Congress

In the past 2 weeks, a pair of biosimilar bills have been introduced to Congress: HR 6179, which would establish a “shared savings” model to encourage physicians to switch their patients to lower cost biosimilars, and S 3466, which would allow $0 co-pays for seniors prescribed biosimilars under Medicare Part B.

HR 6179, the Increasing Access to Biosimilars Act of 2020, would direct CMS to implement a shared savings model for biosimilar prescriptions.

Shared savings is a payment strategy that offers providers a percentage of any net savings realized to encourage them to reduce healthcare spending for a defined patient population. A recent poll, conducted by HarrisX in February, found that 73% of Americans are in favor of sharing savings, a 5% increase from October 2019. The same poll found that 78% of Americans are in favor of $0 co-pays.

The Biosimilars Forum, an advocate of the bill, said that “by sharing savings from lower-cost biosimilars with patients and doctors, patients will benefit from more options for less costly treatments.”

Bill cosponsors, Representatives Tony Cárdenas, D-California; Richard Hudson, R-North Carolina; Brian Fitzpatrick, R-Pennsylvania; and Angie Craig, D-Minnesota, expect the legislation to encourage physicians to prescribe lower-cost medicines, including biosimilars.

“Prescription drug costs have been skyrocketing in recent years, adversely affecting every American. One of the most afflicted groups has been seniors, a majority of whom are on a fixed income and need medication to get through the day,” Fitzpatrick said in a statement. “I’m proud of the work we have done in this bipartisan bill, and I look forward to continuing to fight for our seniors.”

S 3466 was introduced in the Senate by Senators Martha McSally, R-Arizona, and Doug Jones, D-Alabama, and would waive all out-of-pocket expenses for biosimilar products for beneficiaries of Medicare Part B programs. The waiver would apply for the first 5 years that a biosimilar is on the market. This Senate legislation has a companion bill that was introduced in the House in October 2019.

“Congress continues to recognize that the savings potential of biosimilars is the right thing to do for patients, taxpayers, and the healthcare system at-large,” the Biosimilars Forum said in a statement.

A recent analysis showed that reducing patients’ out-of-pocket costs for biosimilars under Medicare Part B with this legislation could save up to $5.2 billion in taxpayer dollars over the next 10 years. The bill is also projected to save seniors as much as $3.3 billion in out-of-pocket costs over the same period, according to the Biosimilars Forum.

Since being introduced to Congress on March 10, HR 6179 has been referred to the Committee on Energy and Commerce as well as the Committee on Ways and Means for a period to be determined by House Speaker Nancy Pelosi. S 3466 has been referred to the Committee on Finance for further review.

The HarrisX poll results suggest that most Americans (65%) still do not know what biosimilars are.