Welcome to the Pharmacy Benefit Brief. This brief is your monthly snapshot of news from America’s prescription drug supply chain including pharmacy benefit managers, independent pharmacies, and drug manufacturers.
Getting the Ball Rolling…
The idea that biosimilars, “generic” versions of expensive brand-name biologic drugs, would be widely available has been anticipated for several years – unfortunately without a lot of progress. But things are starting to change for biosimilars, and that’s resulting in lower drug costs for patients.
First, what is a biologic drug? Biologic drugs, often used to treat complex and rare disease conditions, are produced from living organisms or contain components of living organisms. They can include a wide variety of products derived from humans, animals, or microorganisms by using biotechnology. Biologics are more complicated than other prescription drugs, and therefore the “generic” type versions, called biosimilars, in turn are more complicated to create.
One more thing: biologic drugs tend to be very, very expensive. That’s why the availability of biosimilars is critical for driving down overall prescription drug costs.
The current state of play in the biosimilars market is encouraging. We’ve stated before that pharmacy benefit managers, PBMs, use competition to lower drug costs for patients. Today, there are 18 biosimilars available to patients. For five out of seven of the brand-name biologics with biosimilar competition, net costs have gone down. The same cannot be said for expensive biologics with FDA-approved biosimilars that have not yet been launched.
This trend is promising and shows what PBMs can accomplish when there is competition in the biologic market.
For a deeper dive into this issue, take a look at the blog Rx Corner: Biosimilars vs. Biologics: How About Both?
See a helpful infographic: Biosimilars Competition Reduce Costs
PBM Industry Principles…
This month, we announced a set of PBM industry principles that outline how PBMs interact with employer clients and health plans to provide clear, transparent contracting and deliver affordable pharmacy benefits.
The PBM industry principles reinforce the industry’s commitment to empower employers and plan sponsors with clear contract terms and tools for lowering prescription drug costs, while providing choice in designing contracts to best serve their needs and the needs of the patients they represent.
Take a look at these principles: PBM Industry Principles
Also, check out a couple of videos from employers talking about the value of PBMs.Christopher Goff, CEO and General Counsel of Employers Health, an organization that helps plan sponsors deliver access to high-quality health benefits at a sustainable cost, explains contract choices employers make.
Watch the video: Employers Health Leadership on PBM Contracting
Barry Sloane, CEO of Newtek Business Service Corporation, a business development company that helps small and mid-size businesses run their operations, discusses how PBMs help his company reduce costs and improve access to care.
Watch the video: CEO Describes How PBMs Reduce Costs for Employees
The Latest in Rx News
A new op-ed in Pharmacy Times explains how PBMs have the insight and ability to ensure that people with complex care needs get the most clinically appropriate, cost-effective treatment and ongoing support while eliminating waste to deliver lasting cost savings.
Read the op-ed in Pharmacy Times: How PBMs Can Help Control the Cost of Specialty Medications
