Amid ongoing debate over biosimilar use in the United States, a new government analysis found that Medicare Part D spending on biologic medicines in 2019 could have been reduced by $84 million, or 18%, if they had been used more frequently — and beneficiaries themselves could have saved $1.8 million.
The potential savings were minimized because not all Medicare Part D health plans covered biosimilars, which are nearly identical variants of pricey biologic medicines that yield the same health outcomes. And the health plans that did cover biosimilars “rarely encouraged” prescribing, the analysis noted. Instead, the plans favored costlier, brand-name biologics on formularies, or lists of covered medicines.
The findings are the latest to suggest that biosimilars, which are typically priced at 20% to 30% less than brand-name biologics before discounts, can provide needed savings to the U.S. health care system. But the analysis, which was run by the Office of the Inspector General of the U.S. Department of Health and Human Services, underscores concerns about the extent to which biosimilars can fulfill their promise.
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