In advance of President Donald J. Trump’s State of the Union address, the Biosimilars Forum reinforced the urgent need to support the biosimilars market, which would unlock billions in health care savings for taxpayers. Biosimilars, the second generation of lower-cost medicines, present an opportunity to save as much as $150B over the next decade—with an on-average savings of 25 percent compared to the brand name product.
“We urge the President, his administration and Congress to enact simple policy changes that can lower drug costs by increasing access and use of biosimilars. These lower-cost, life-changing medicines experience single digit use in a majority of states. As a result, the U.S. lost as much as $7B dollars in unrealized savings last year alone. As President Trump looks to fulfill his promise of lowering drug costs for our nation’s seniors and taxpayers, he can and should include biosimilars as a critical part of the solution,” said Juliana Reed, President of the Biosimilars Forum.
Biologics are currently the biggest driver of drug spending in the Medicare program. Biosimilars are FDA-approved, equally safe and effective lower-cost alternatives. Millions of Americans rely on these treatments for some of life’s most serious diseases, including cancers, rheumatoid arthritis, psoriasis, inflammatory bowel disease, and Crohn’s Disease. Yet several market and regulatory barriers hinder patient access to these critical drugs, leading to higher costs for patients and the health care system at-large.
Last year, the administration’s FY2020 budget proposal called for “harnessing payment and cost-sharing incentives to increase biosimilar adoption.”
“President Trump, with the stroke of a pen, can keep his promise to lower drug prices by increasing patient access to lower-cost, safe and effective biosimilars. For example, the administration could direct CMS to implement a biosimilars shared savings program for Medicare Part B, which would share some of the new Medicare savings with patients and prescribers and thus would encourage doctors to use biosimilars over a more expensive reference biologic,” said Reed.
Congress has also recognized the cost-saving potential of biosimilars, taking bipartisan action in the House on three key policies, two of which were also included in the Senate Finance Package in July, that would save patients and taxpayers billions of dollars over the next decade:
- Acting to Cancel Copays and Ensure Substantial Savings for Biosimilars (ACCESS). This bipartisan bill would waive patients’ out-of-pocket costs for biosimilars under Medicare Part B.
- Bolstering Innovative Options to Save Immediately on Medicines (BIOSIM) Act that would enhance provider reimbursement by increasing the ASP add-on payment rate for biosimilars in Medicare Part B. A similar bill was part of the Senate Finance Package in July.
- Star Ratings for Biosimilars Act that would implement an access measure to incentivize Medicare Advantage and Part D plans to improve access to biosimilars on their formularies. This legislation was included as a provision in the Senate’s Finance Package in July.
These money-saving policies should be enacted by Congress or by President Trump himself to answer the millions of calls by hard-working Americans to lower drug costs.
For more information on these policies visit supportbiosimilars.com.