The Biosimilars Forum Applauds HHS Proposal to Target Costly Rebates Structure Blocking Patients from Biosimilars and Savings

WASHINGTON, D.C. (January 31, 2019) – The Biosimilars Forum applauded today’s proposed HHS rule attacking negotiated rebates between manufacturers and insurers, issuing the following statement:

“Currently, these rebate deals between insurance companies and manufacturers are standing in the way of patients accessing lower cost biosimilars. The system has been rigged to reduce competition by pushing out lower cost options from the market and force patients to use more expensive medicines where insurance companies or PBMs pocket the rebates. Biosimilars are an option that could provide nearly $54 billion in healthcare savings over the next decade, but patients need to be able to access them to realize their savings. All parts of Medicare need to have the proper incentives in place to support a robust biosimilars market. We applaud the Administration for starting this dialogue and look forward to working with them on policies to bring patients savings and greater access to life-changing treatments.”

As HHS noted, the current rebate system discourages the use of safe, effective lower-priced generics and biosimilars.

Today’s HHS Fact Sheet highlighted:

“A growing number of Part D plans have moved generic drugs to non-preferred tiers, and we have yet to realize the potential of biosimilar competition for high-cost biologics. Too often, this is because insurers and Part D plan sponsors can extract higher rebates for brand drugs and biologics. At the same time, manufacturers of brand drugs and biologics can prevent generic or biosimilar competition by increasing the size of the rebates they pay for a drug or group of drugs, and condition the payment of those rebates on maintaining their exclusive formulary position. This makes it easier for PBMs and insurers to collect bigger rebates on already-existing sales volume than it is to lower drug spending by using lower costs drugs. Excluding rival drugs with “rebate walls” or “bundled rebates” distorts our free market system, discourages generic competition and biosimilar adoption, and causes patients to pay more out of pocket.”