Senators Cornyn and Bennet Introduce Bipartisan Legislation to Incentivize Biosimilars, Lower Cost for Seniors
New Bill Enhances Provider Reimbursement of Biosimilars, Lowering Medicare Part B Spending
WASHINGTON, D.C. – Senators John Cornyn (R-TX) and Michael Bennet (D-CO) this week introduced the Increasing Access to Biosimilars Act (S. 1427) to enhance physician reimbursement when prescribing biosimilars, realigning incentives to increase utilization of lower-cost biosimilars in Medicare Part B and generate significant health care savings. Similar legislation (H.R. 2869) was also introduced this week in the House of Representatives by Representative Tony Cárdenas (D-CA).
Biosimilars are just as safe and effective as brand name biologics, but cost less—making them a key part of the solution to lowering health care costs. This bipartisan bill will help generate health care savings by encouraging biosimilar use,” said Meaghan Smith, Executive Director of the Biosimilars Forum. “This common-sense policy is also a win for taxpayers given brand name biologics make up the top ten most expensive drugs in Medicare Part B.
Texans who need life-saving medication shouldn’t have to pay through the nose when there are lower-cost alternatives,” said Senator Cornyn. “This bill would lower Texans’ out-of-pocket costs while creating savings for Medicare, and I’m proud to offer a bipartisan solution to help drive down the cost of prescription drugs.
The skyrocketing cost of prescription drugs was a problem in this country before the pandemic. Now, even more Americans have to choose between their life-saving medications and putting food on the table, especially seniors, communities of color, and the millions of people living on fixed incomes who need their prescriptions to live,” said Senator Bennet. “This legislation would increase patient access to lower-cost biosimilars, saving them and our health care system billions of dollars. I look forward to working with my colleagues on both sides of the aisle to move this legislation forward.
We need to do everything we can to make sure Americans have access to the life-saving medicine they need,” said Congressman Cárdenas. “My bill reduces the cost of expensive prescription drug prices while also encouraging healthy competition in the marketplace. It is unconscionable that in the greatest and wealthiest country in the world there are working families that are forced to choose between putting food on the table and potentially life-saving medication.
Physicians play an important role in biosimilar adoption and while research shows they are increasingly comfortable with and willing to prescribe biosimilars, backward incentives and barriers have prevented widespread adoption. Reimbursement policy does impact biosimilar use, with an IQVIA report showing that providers are less likely to adopt a biosimilar when a brand name biologic has a higher reimbursement ratio—defined as the difference between a product’s payment rate and acquisition price.
For too long, misaligned incentives have forced physicians and patients to use higher cost products,” Smith said. “This legislation will help break that cycle.
The Increasing Access to Biosimilars Act creates a new pilot program that encourages physicians to prescribe less expensive biosimilars through shared savings, increasing patient access to more affordable treatments and generating savings for taxpayers. Shared savings is a payment strategy that offers providers a percentage of any net savings generated to encourage reduced health care spending. Research shows that this type of model can lower Medicare Part B spending. A HarrisX public opinion poll also found that 73% of Americans favor a shared savings model for biosimilars.
Similar legislation to establish a shared savings model has previously garnered bipartisan support and today’s action builds on the legislative momentum to increase biosimilar utilization, including the signing of the Advancing Education on Biosimilars Act of 2021 (S. 164) into law in April, and the introduction of the Star Rating for Biosimilars Act (H.R. 2855) and the Bolstering Innovative Options to Save Immediately on Medicines (BIOSIM) Act (H.R. 2815).