As the world of pharmacy moves forward, biologic medications are becoming ubiquitous and bring with them positive changes for patients nationwide. These medications have the potential of saving thousands of dollars each year in medical costs by providing good patient outcomes and sustainable management of complicated and hard-to-treat disease states. However, with the advent of these medications comes high costs due to production value as well as the limited number of agents in each class. Biosimilars, a term coined for “generic” biologic products, offer a potential solution to this problem.
Biosimilars are exactly as their name connotes. These agents mimic biologic medications in their mechanism of action and are able to be approved through the Biologics Price Competition and Innovation Act (BPCI Act) at a faster rate than biologics being approved for the first time. Despite the hastened timeline, the FDA still requires strict approval standards for biosimilars to be approved for patient use, so both patients and practitioners can be assured that their medications are safe and effective.
There are currently 29 FDA-approved biosimilars for use in the US by the FDA, with 17 of them being readily available on the market. Each of these offers another contender on the market to act as competition against more expensive brand name medications. Due to the decreased production costs with expedited market arrival, biosimilars can offer substantial savings over their biologic counterparts. One of the first biosimilars to hit the market, Inflectra, costs approximately $750 per 100 mg, where its prototypical biologic brand counterpart, Remicade costs approximately $1,150 per 100 mg, amounting to a 45% reduction in cost. One of the newest biosimilars on the market, Riabni, is a biosimilar for Rituxan and offers 25% cost-savings.
As biosimilars gain more traction in the prescription drug market, cost-savings and utilization benefits will continue to improve. While biosimilars are not commonly prescribed now, increased market entry and utilization will force competitor companies to decrease the price of their more expensive biologics, slowly decreasing the overall cost of these specialty medications.
Biologic medications make up only 2% of prescribed medications but account for almost 40% of medication costs each year, as of 2017. As the number of prescribed biologics increase, the vast cost of these medications will also add up. Biosimilars create an opportunity for companies to save money by referring their physicians and patients to these alternatives.
As biosimilars continue to be approved and marketed, it’s important to address whether these agents are appropriate for formularies and approval criteria for insurance and PBM companies. Due to their decreased cost and FDA-verified efficacy, they are clearly drugs to be evaluated as they reach the market. Profero Team, LLC has a team of pharmacy staff that are constantly reviewing and monitoring biosimilars as they enter the market. Our team is well-equipped to view the clinical data behind each approval and watch prices to ensure companies are receiving the best possible value based on formulary decisions. If you are interested in learning more about biosimilars and how they can save your company thousands of dollars each year, reach out to the Profero Team today!
Biosimilars. The Food and Drug Administration (FDA) Website. https://www.fda.gov/drugs/therapeutic-biologics-applications-bla/biosimilars. Updated February 3, 2020. Accessed February 16, 2021.
Biosimilar Product Information: FDA-Approved Biosimilar Products. FDA Website. https://www.fda.gov/drugs/biosimilars/biosimilar-product-information. Updated December 17, 2020. Accessed February 16, 2021.
Redbook. Micromedex Solutions. Greenwood Village, CO: Truven Health Analytics. 2021. Accessed February 16, 2021.
“Medicine Use and Spending in the U.S.: A Review of 2017 and Outlook to 2022.” IQVIA Website. https://www.iqvia.com/institute/reports/medicine-use-and-spending-in-the-us-review-of-2017-outlook-to-2022. Accessed February 16, 2021.