Biologics & Biosimilars

Biosimilar competition did not reduce out-of-pocket spending, study finds

April 1, 2024 - Biosimilar competition did not lower out-of-pocket spending on biologics for commercially insured individuals, a study published in JAMA Health Forum found. Prescription drug spending in the United States is higher than in any other country, surpassing $500 billion in 2021. High-cost biologics are often a contributor to these expenses. Policymakers...

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Humira Price for Commercial Plans Remained Steep Despite High Rebates

by Victoria Bailey

Despite increasing rebates, the net price of Humira for Medicaid and commercial health plans in 2020 remained high above the launch price, according to a study published in JAMA Network Open. The...

Cigna Healthcare Boosts Treatment Access with New Biosimilar Coverage

by Victoria Bailey

Cigna Healthcare has added four Humira biosimilars to its formularies, aiming to increase member access to affordable treatments. Cigna Pharmacy Management, Cigna’s provider of pharmacy...

National Alliance Playbook Guides Employers on Biosimilar Adoption

by Kelsey Waddill

The National Alliance of Healthcare Purchaser Coalitions (National Alliance) has announced the publication of its playbook which aims to encourage biosimilar adoption among employers. “If...

Feds Share Details on Inflation Rebates for Medicare Prescription Drugs

by Kelsey Waddill

The Department of Health and Human Services (HHS) and CMS have lowered prices for over two dozen Medicare prescription drugs including biologics for a set timeframe. Starting on April 1, 2023,...

Inflation Reduction Act Takes Effect: Biosimilar Payment Boost for Medicare

by Kelsey Waddill

CMS and the Department of Health and Human Services (HHS) have initiated certain elements of the Inflation Reduction Act related to biosimilars. On October 3, 2022, the statements from the Inflation...

OIG: CMS Should Promote Biosimilars To Reduce Part D Spending

by Kelsey Waddill

Policymakers should consider increasing access to and promoting the use of biosimilars and monitoring trends in biosimilar coverage in order to bring down Medicare Part D spending, the Office of...

Employers Identify Key Biosimilar Strategies, Knowledge Gaps

by Kelsey Waddill

By shifting plan design, formulary design, drug pricing, drug availability, and sites of care and drug administration,  employers can create a health plan that is more accommodating for...

Payers Recommend Actions To Promote Biosimilars, Drug Competition

by Kelsey Waddill

The Food and Drug Administration (FDA) and Federal Trade Commission (FTC) can streamline the biosimilar approval process and adopt other strategies to promote biosimilars and lower healthcare spending,...

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