Biosimilars Forum Applauds CMS Decision to Reverse Existing Rule on Biosimilar Reimbursement Policy

WASHINGTON, D.C., November 2, 2017 –The Biosimilars Forum applauds the Centers for Medicare and Medicaid Services (CMS) decision to reverse the existing policy on biosimilar reimbursement that has been in effect since January 1, 2016.

“The Biosimilars Forum is delighted to learn of CMS’ decision, which is a huge win for patients,” said Stacie Phan who heads the Biosimilars Forum. “It’s clear that CMS valued the additional thought and analysis provided by the countless number of stakeholders who expressed concern that the long-term stability of the biosimilar market would be jeopardized unless they reconsidered its policy.”

Issuing unique Healthcare Common Procedure Coding System (HCPCS) codes to each individual biosimilar is essential to ensuring a robust, competitive biosimilar market by increasing the potential for innovation while lowering the risks associated with developing and marketing these complex products.

The Forum and nearly 200 patient and physician organizations, and other stakeholders have argued that the law, legislative history, and biosimilar science support the requirement that CMS assign each biosimilar biological product a unique HCPCS code and not consider biologics and biosimilars in the same fashion as generic drugs.
“A robust U.S. marketplace is critical for American patients and even more important when one considers the costs savings potential that they represent,” Phan said. “Further, a recent RAND study suggests savings of $54 billion from biosimilars over the next decade, with most savings passed on to patients and taxpayers in the long-term.”

“The Biosimilars Forum will continue to work with stakeholders and CMS as the updated policy is implemented,” Phan concluded.

About the Biosimilars Forum

The Biosimilars Forum is a nonprofit organization whose mission is to advance biosimilars in the United States with the intent of expanding access and availability of biological medicines, and improving health care. The founding members of the Biosimilars Forum represent the majority of companies with the most significant U.S. biosimilars development portfolios.

To learn more about biosimilars, the Forum, and how to get involved, visit, or Facebook/USBiosimilars to follow related conversations and join the dialogue.

Aimee Steel Lubin