Two years after biosimilars became available in the U.S., a higher proportion of patients using brand-name biologics were paying out-of-pocket costs, which were also, on average, 12% higher than before, according to a recent study. In addition, patients who used biosimilars often did not pay lower out-of-pocket costs than those who were given brand-name biologic medicines. Although the trends varied widely by drug, the authors argued their findings suggest the heralded arrival of biosimilars — which are nearly identical variants of brand-name biologics but yield the same health outcomes — failed to fully deliver on their promise.
Biosimilars may have lowered health care spending and insurance premiums, but did not produce sufficient direct savings for many patients, they maintained. “The whole purpose of biosimilars was to introduce competition into the marketplace and lead the [U.S.] health care system to affordable medications,” said Benjamin Rome, one of the study authors and a faculty member at the Program on Regulation, Therapeutics, and Law at Harvard Medical School and Brigham and Women’s Hospital. “The fact that it’s so hard to find savings consistently is disappointing.”
The study was published in the journal Health Affairs. The researchers analyzed data from a large insurer that covered more than 20 million people. They found that the proportion of patients paying out-of-pocket costs for brand-name biologics increased from 22% in 2015 to 27% in 2017. The average out-of-pocket cost for brand-name biologics also increased from $2,400 in 2015 to $2,700 in 2017.
The researchers also found that patients who used biosimilars often did not pay lower out-of-pocket costs than those who were given brand-name biologic medicines. In fact, in some cases, patients who used biosimilars paid more out-of-pocket costs than those who used brand-name biologics.
The researchers said their findings suggest that the arrival of biosimilars has failed to fully deliver on their promise of lower costs for patients. They said more work is needed to understand why patients are not seeing the savings that were expected from biosimilars.
