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The Payer’s Unique Perspective on Biosimilars
With the introduction of biosimilars into the US market, payers and plans are anticipating how their organization will react. In Amgen’s 2015 Trends in Biosimilars Report, payers shared their opinions on the adoption of biosimilars including how their plans will perceive biosimilars, their priority level of adopting biosimilars, and the reason for covering biosimilars in their plans.
According to the trends report, 43% of payers strongly agree that biosimilars represent a viable and compelling business opportunity for their plans. Forty-five percent agree biosimilars represent a viable and compelling business opportunity for their plans, 8% neither agree nor disagree, and 5% disagree.
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When it comes to the future of biosimilars, 80% of payers perceive that their plans will treat them like a lower-cost branded option, 17% believe their plans will treat biosimilars like a small molecule generic, and 3% do not expect that any biosimilars will launch in the United States.
Multiple health care organizations consider preparing for biosimilar entry into the US market a high or somewhat high priority including accountable care organizations, integrated delivery networks, national managed care organizations, pharmacy benefit managers, regional managed care organizations, and Veteran Affairs. Benefit consultants consider preparing for biosimilar entry into the US market a moderate priority.
When payers were asked what was the primary driver for covering biosimilars, 73% said cost containment, 14% said expanded access, 11% said enhanced patient experience, and 3% said other.—Melissa D. Cooper
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