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The Impact of Lower Cost Alternatives or Biosimilars on The Cost of Key Cancer Drugs

Grace Taylor

A recent study by Puneeth Indurlal, MD, MS, The US Oncology Network, McKesson, The Woodlands, Texas, and colleagues examined pricing trends of key cancer drugs and the impact of lower cost or biosimilar alternative (LCA) drug introductions on their prices. The researchers’ findings were presented at the 2023 ASCO Quality Care Symposium in Boston, Massachusetts. 

The price of cancer drugs has a large impact on overall cancer spending in the US. In many cases, these price increases outpace consumer price index (CPI) inflation, and impact patient access to cancer care, their treatment outcomes, and cost sharing. 

Using Medicare (Part B and Part D) data from 15 US Oncology Network practices, Dr Indurlal and colleagues analyzed the costs of the top 30 cancer drugs from July 2016 to June 2022. Next, they compared the costs of these drugs before and after the introduction of lower cost alternatives or biosimilars.

Overall, during the Oncology Care Model period, there was an increase in mean drug costs of 12.3% (range: -41.8% to 39%) for Part B drugs and 46.2% (range: -67.5% to 278.2%) for Part D drugs, with many of these cost increases surpassing consumer price index (CPI) inflation. Paclitaxel—a Part B drug—and ibrutinib—a Part D drug—had the largest cost increases at 39% and 278.2%, respectively. 

The study also found that after LCA drugs were launched, there was a decrease in the cost of Part B drugs by -11% and Part D drugs by -39%, with a mean decrease of 36%. When LCAs were not available, Part B and Part D drugs had a cost increase of 21% and 67%, respectively, with a mean increase of 22%. Part D drugs rose 3.75 times faster than Part B drugs, often outpacing CPI inflation.

“The impacts of evergreening drug patents and potential shifting of drug coverage from Part B to Part D on costs are ripe for evaluation,” said the authors. They recommend that the Part D coverage changes in the Inflation Reduction Act be monitored for their potential impact on the price of cancer drugs, their affordability, patient access, and financial toxicity issues. 


Indurlal P, Wilfong LS, Garey JS, Busby LT, Feinberg E. Trends of cancer drug cost increases and impact of generic and biosimilar drug launches. Presented at: the 2023 ASCO Quality Care Symposium; October 27-28, 2023; Boston, MA, and virtual; Abstract 19.

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