PBMs Support and Encourage Biosimilar Competition
Increased biosimilar competition drives down prescription drug costs
Having multiple biosimilar and reference biologic competitor products with equivalent patient benefits on the market allows pharmacy benefit companies, PBMs, to push manufacturers to compete on pricing and provide patients and payers with the lowest-cost products. The release of more biosimilars has enhanced the competitive marketplace for biologics.
PBMs Support the Proliferation and Use of Biosimilars
PBMs value biosimilars and support efforts to increase the number of biosimilars coming to market because increased competition drives down costs.
New research looking at trends in commercial medical benefit coverage and price over time has found that in three disease areas biosimilar coverage is increasing, while prices are decreasing, which creates a more competitive marketplace with more choices for patients and providers.
RESEARCH SHOWS US
Prices Fell
Average sales prices (ASPs) for biosimilars and their reference biologics declined up to 24.5 percent between 2018 and 2021, with some biosimilar prices declining faster than reference biologics.
More Coverage
Biosimilar coverage in commercial medical benefits increased by 36.5% percentage points to a 92 percent coverage rate in 2021, meaning greater coverage and access to biosimilars.
The Matrix Global Advisors Improvements in Medical Benefit Coverage of Biosimilars research shows that commercial medical benefits coverage of biosimilars in three disease areas (breast cancer and non-small cell lung cancer, colorectal cancer and chronic lymphocytic leukemia, and neutropenia) has been increasing since 2019, as the average sales prices (ASPs) of these biosimilars have been declining.
The study shows that biosimilars have reached coverage parity with reference biologics and have also increasingly received preferred coverage in benefit designs. The decline in ASP for biosimilars is positively correlated with the decline in their lack of coverage on medical benefits. In other words, as biosimilar prices have decreased, coverage and patient access have increased.
