Bipartisan introduction of legislation from Representatives Tonko and Gibbs will direct the U.S. Department of Health & Human Services (HHS) to create a biosimilar access measure in the Centers for Medicare & Medicaid Services’ (CMS) Star Ratings Program. This measure will help Congress and the industry better understand patients’ use of or ability to access lower-cost biosimilars in the Medicare Advantage and Part D health plans.
The Biosimilars Forum issued the below statement applauding the introduction of H.R. 4629 Star Ratings for Biosimilars Act:
As President Trump and Congress look for ways to reduce health care costs and ensure patient access to lower cost therapies, CMS must take this opportunity to save seniors and taxpayers money. Congressmen Tonko and Gibbs understand the importance of identifying inefficiencies in health plans that are blocking patient access and use of lower-cost biosimilars to treat some of life’s most complex illnesses. Through this measurement, it will allow for reforms that will encourage health plans to drive significant savings in health care.
Biosimilars have the potential to save seniors and taxpayers as much as $54 billion, but we won’t be able to unlock these savings unless we are able to remove the barriers to access. Biosimilars still face very low market share and utilization in the U.S. Without simple policies changes, we won’t be able to drive savings in the system. Just last week, the Pacific Research Institute (PRI) released a state-by-state analysis showing that if lower-cost biosimilar represented 75% of the current market, the U.S. could save as much as $7 billion annually — alleviating hundreds of millions of dollars in spending for state budgets across the U.S.
“Policymakers, including Representatives Tonko and Gibbs, have rightfully recognized that increasing access to biosimilars will be a necessary part of the solution to lowering health care costs. The Forum encourages Congress and President Trump to act quickly to increase biosimilars use to unlock billions in savings and alleviate the financial burden on millions of Americans suffering from high drug costs.”
In the last two months, congressional members on both sides of the aisle have introduced legislation that would reduce out-of-pocket costs for biosimilars and incentivize physicians to proactively provide these safe, lower cost therapies. This policy released today to implement a Star Ratings measurement for biosimilars, in addition to the existing proposals, will ultimately help alleviate the financial burden on millions of our nation’s seniors, patients and taxpayers.
For more information on the potential savings that can be realized with increased access to biosimilars, visit supportbiosimilars.com.