New Analysis of Policies Incentivizing Biosimilars Could Save U.S. Taxpayers Billions in Health Care Costs and Medicare Beneficiaries up to $3.3B in out-of-pocket costs over 10 Years.
The Biosimilars Forum recently released new scoring analysis, which it commissioned from Avalere Health, on three policy proposals to increase use of and patient access to biosimilars. The policies are estimated to save billions in federal health care costs and Medicare beneficiaries up to $3.3B in out-of-pocket costs over the next ten-year budget window. The Forum called on Congress to consider the policies to lower health care costs.
Biologics are currently the biggest driver of drug spending in the Medicare program. Despite being FDA approved, equally safe and effective, and lower in cost than specialty biologics, biosimilars have faced barriers in the public and private insurance markets, preventing their rapid adoption in the U.S.
As Congress works to lower health care costs, the Forum believes this analysis demonstrates biosimilars are an obvious solution to quickly lower costs for both patients and American taxpayers. Already, the administration’s FY2020 budget proposal calls for “harnessing payment and cost-sharing incentives to increase biosimilar adoption.”
“It’s clear that incentivizing biosimilars will lower health care costs for patients and taxpayers,” said Juliana Reed, President of the Biosimilars Forum. “Today’s scoring analysis proves that biosimilars need to be part of the solution to lower health care costs, but it will require proactive policy action to unlock these savings. By reducing patients’ out-of-pocket costs and encouraging doctors to use biosimilars instead of the more expensive biologic, the U.S. can save billions for patients and Medicare.”
To determine the economic impact of increased use of biosimilars, the Forum commissioned Avalere Health to score three policy solutions to understand the potential costs or savings to the federal government. To evaluate the potential impact on government spending of such a proposal, Avalere prepared 3 scenarios based on a range of assumptions. Based on the findings from the high scenarios, each policy could lead to billions in cost savings each year. The three policies and their respective estimated savings are below:
1. Reducing Patient Out-of-Pocket Costs for Biosimilars:
2. Biosimilars Shared Savings Program for Providers:
3. Additional Add-On Payment for Biosimilars:
The complete details of the three policies proposals and scoring analysis can be found at supportbiosimilars.com/policies.
SOURCE: Biosimilars Forum