Wrapped in employer insurance plans, biosimilars can be more expensive

Although biosimilars are usually cheaper than biologic brand-name drugs, a patient’s insurance plan can have a lot of sway in biosimilar drug prices, a recent study found. 

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Biosimilars are generic versions of biologic drugs, which have risen in cost over the years. These generics have been projected to save the U.S. $38.4 billion in biologic spending, but individual savings can differ if a patient isn’t a Medicare enrollee. 

When comparing Medicare savings for chemotherapy drug Zarxio, a biosimilar approved by the FDA in 2015, to the brand-name drug it was based on, Neupogen, researchers from the Health Care Cost Institute found about a 30 percent difference in cost savings. 

Between 2015 and 2020, Zarxio’s prices were about 20 percent lower than the brand-name option for employer-sponsored insurance plans, but those savings were nearly halved for Medicare enrollees. 

“Savings from lower biosimilar drug acquisition costs are not directly translating to lower negotiated administered drug prices for ESI enrollees,” the researchers wrote.

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