May 30, 2019 - Health

How Medicare can help biosimilar uptake

A new analysis finds that relatively minor changes to Medicare's payment policies could help jump-start the fledgling market for biosimilars.

Where it stands: The market for biosimilars is weak, and that means the drugs' expected savings aren't materializing. But Medicare could help kick things up a notch, according to Avalere estimates commissioned by a coalition of biosimilars manufacturers.

By the numbers: According to Avalere's calculations, biosimilars could reach somewhere between 26% and 46% market share if Medicare picked up the tab for seniors' out-of-pocket costs for the drugs.

  • That approach could save the government as much as $5 billion and seniors as much as $3 billion over 10 years, depending on the details, the analysis says.

How it works: Doctors' financial incentives matter just as much as patients', since most biologics and biosimilars are administered at a doctor's office.

  • Medicare could save billions over the long run by simply tacking on a payment bonus for biosimilars, the analysis says.
  • Letting doctors share in the savings that biosimilars bring to Medicare wouldn't save as much money, but would do more to help biosimilars as a class gain a stronger competitive footing.

Go deeper: How to jump-start a fledgling class of new, cheaper drugs

Go deeper