With the recent launch of a new adalimumab biosimilar, the U.S. biosimilar market is becoming more competitive, increasing the potential for these more affordable options to play a critical role in helping to lower prescription drug costs for Americans.

As biosimilar competition increases for prominent biological drugs, some pharmacy benefit companies are preferring both the brand and biosimilar. The market will continue to develop as more competitors enter, and as we have seen with other biosimilars, coverage will increase as prices decline.

Former Food and Drug Administration Commissioner Scott Gottlieb, M.D., explained during PCMA’s recent Policy Forum how biosimilars are helping to secure savings as more of these alternatives to high-priced brand name products enter the market.  He said:

“…I think what you’ve seen is a robust market taking shape where there’s multiple entrants. There have been biosimilar launches that have failed, but there’s been a lot that have been successful. I think the companies in this space have figured out how to sell a biosimilar. The price savings that you’re seeing are substantial.”

Health policy researcher and CEO of Matrix Global Advisors, Alex Brill, released a white paper in the spring, “Near-Term Expectations for Adalimumab Biosimilars in the United States,” which “explores the long-awaited moment and the expected transition from a monopolistic adalimumab market to a competitive marketplace with multiple biosimilars.” The report highlights that, “Robust competition is needed to drive down prices, and biosimilar competitors need time to achieve stable, sustainable prices consistent with market demand.”

Brill published a new blog describing the potential for competition and lower costs with the introductions of more biosimilars in the U.S. market. He said:

“For the lower-concentration versions, competition will now become more robust as [drug manufacturers] will suddenly have six competitors. One biosimilar manufacturer…has already set the tone with the recent announcement that they will partner with Mark Cuban’s Cost Plus Drug Company to sell their adalimumab biosimilar, Yusimry, at an 85 percent discount from the Humira list price… In the pharmacy benefit, formulary placement drives utilization. Therefore, it is significant that PBMs have begun adding adalimumab biosimilars to their formularies…

“Competitive pressures will begin to intensify this summer, followed by savings. But the learning curve among pharmacy benefit participants still exists. And the greatest savings won’t materialize until more high-concentration, and perhaps interchangeable, biosimilars enter the market.”

More affordable options like biosimilars increase competition in the marketplace, which is critical to lowering costs for patients and families. Taking steps to increase patient access to biosimilars, reduce barriers created by big drug companies, and promote competition among biologic drugs is critical to achieving a more affordable future.

Patent abuse that blocks biosimilars from the market will cost patients an estimated $30 billion over the next decade — on top of the $5 billion from already lost biosimilar competition between 2015 to 2020.

PCMA continues to advocate for policy changes that will put an end to big drug companies’ anti-competitive tactics and increase biosimilar uptake. Policy recommendations include:

• Remove the interchangeable designation or streamline the process to achieve interchangeability to increase biosimilar uptake and reduce confusion.
• Enable plan flexibility.
• Prohibit anti-competitive practices that unnecessarily extend branded biologic monopolies.
• End drug companies’ “pay for delay” agreements.
• Revise the innovator biologic exclusivity to seven years.

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Read highlights and listen to our most recent episode of “The Pharmacy Benefit” podcast on why we need competition to drive down prescription drug costs HERE.

See our recent blog highlighting a recent webinar where a robust panel of experts discussed the U.S. biosimilar market HERE.

Read more from PCMA on how greater biosimilar competition can help lower prescription drug costs HERE.

See PCMA’s guide to understanding the role and value of pharmacy benefit companies HERE.

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PCMA is the national association representing America’s pharmacy benefit companies. Pharmacy benefit companies are working every day to secure savings, enable better health outcomes, and support access to quality prescription drug coverage for more than 275 million patients. Learn more at www.pcmanet.org