Biosimilars have had such an impact on driving down costs, that in some instances the reference product might be the lowest cost option, explained Paul Forsberg, PharmD, director of pharmacy, Minnesota Oncology.
Biosimilars have had such an impact on driving down costs, that in some instances the reference product might be the lowest cost option, explained Paul Forsberg, PharmD, director of pharmacy, Minnesota Oncology.
Transcript
What role does the reference product play when 1 or more biosimilars enter the market?
The reference product continues to really play a key role. Like anything else, it's nice to have that initial product that we're always comparing the biosimilar products to. What we found was as more biosimilars hit the market space, the reimbursements from a Medicare standpoint—not only for the biosimilars, but for the reference products—have continued to decline over time since the launch of the biosimilar. The biosimilar launch has had a good impact on the reimbursement for those reference products.
It gives us the flexibility to move between the biosimilar and to a reference product, if the reimbursement from a Medicare standpoint has helped reduce cost for the reference products. We find that some of the medical policies that we're seeing from payers include one of the biosimilar products and the reference product included in it. If there's a biosimilar product that we cannot obtain, if there's a biosimilar product that we're trending to be underwater with that biosimilar, we still have the flexibility to pivot back to that reference product.
We also found in one of the spaces, in the pegfilgrastim space, that the reference product from a Medicare ASP [average sales price] reimbursement standpoint has actually been the lowest-cost product in that space, which is something that I don't know if a lot of people predicted. The biosimilars have driven down the cost of the reference product so much to the point that the reference product was the lowest-cost product in the space, [and] we're able to continue to utilize the reference product and the Onpro-type device, which improved patient access to treatment, while we continue to monitor that biosimilar pricing.
I think the key point, at this point, with the reference products in the biosimilar rollout has been able to maintain a competitive cost balance, which allows us to keep a close eye on it and make sure that we are moving toward the lowest-cost product whenever possible.
Study Highlights Significant Increases in Utilization, Spending on DMD Drugs in Medicaid
May 17th 2024The findings add to recent research on the growing utilization, expenditure, and prices of Duchenne muscular dystrophy (DMD) therapies in the current landscape, an area health care policy could potentially address.
Read More
Frameworks for Advancing Health Equity: Urban Health Outreach
May 9th 2024In the series debut episode of "Frameworks for Advancing Health Equity," Mary Sligh, CRNP, and Chelsea Chappars, of Allegheny Health Network, explain how the Urban Health Outreach program aims to improve health equity for individuals experiencing homelessness.
Listen
Panel Addresses Minority Physician Shortage, Maternal Health at Senate Committee Hearing
May 15th 2024The senate hearing held by the US Senate Committee on Health, Education, Labor, and Pensions, led by Sen. Bernie Sanders (I, Vermont), chairman of the committee, and ranking member Sen. Bill Cassidy, MD, (R, Louisiana), addressed the critical issue of physician and health care worker shortages, as well as the maternal health crisis, in the US.
Read More
Tackling Health Inequality: The Power of Education and Experience
April 30th 2024To help celebrate and recognize National Minority Health Month, we are bringing you a special month-long podcast series with our Strategic Alliance Partner, UPMC Health Plan. Welcome to our final episode of this limited series and our conversation with Janine Jelks-Seale, MSPPM, director of health equity at UPMC Health Plan.
Listen
Bleeds and Resource Use in Hemophilia B: Retrospective Observational Study
May 15th 2024This real-world US study describes individuals with hemophilia B who experience bleeds despite factor replacement therapy and quantifies the associated comorbidity and health care resource utilization burden.
Read More
A new study highlights significant disparity in reimbursement rates across states between hospitals and Medicare; the first patient to receive a genetically modified pig kidney has died; research examines outcomes of over 500 patients receiving medication abortion pills by mail.
Read More