Opportunities Remain as US Biosimilar Adoption Advances

The US has trailed Canada and Europe in adopting biosimilars, but the gap is narrowing, according to James Chambers, PhD, MPharm, MSc, professor at Tufts Medical Center, who spoke at the Academy of Managed Care Pharmacy Nexus 2026 meeting in San Diego, California.

Chambers was a panelist during the session “Repositioning of Biosimilars: How Can the US Optimize Biosimilar Utilization to Improve Patient Health and Lower Total Cost of Care?” He said biosimilars are now much more accepted in the US than they were in the past, pointing to research on payer coverage policies for biologics.

In 2017, 55% of policies covering originator biologics and their biosimilars required patients to fail the originator product before they could access the biosimilar, Chambers noted. By 2025, that share had fallen to 6%, with biosimilars as the preferred product in 94% of policies.

“…through the payer lens, we’ve seen great advancement in how they prioritize biosimilars over time,” Chambers said. “Now, I think there’s still room for improvements.”

He argued that biosimilars have not reached their full potential, particularly in enabling earlier access to biologics in the treatment pathway, using ulcerative colitis as an example. The American College of Gastroenterology recommends biologics as first-line treatment or as an option for first-line use. However, payers typically require patients to complete conservative therapy before they can access a biologic. Because biosimilars can substantially lower biologic treatment costs, they create an opportunity to align payer policies more closely with clinical guidelines, Chambers said.

He also highlighted an international example from a report he contributed to at the Office of Health Economics in London, which compared repositioning across regions. In the UK, the National Institute for Health and Care Excellence (NICE) declined to recommend bevacizumab (Avastin; Genentech) for metastatic colorectal cancer 3 times. After a bevacizumab biosimilar entered the market, NICE revised its decision, and the report estimated substantial health benefits from the change.

“…this repositioning is nascent,” Chambers concluded. “It’s new, and I think that’s where, hopefully, we see changes and where biosimilars really begin to benefit patients in the future.”