Biden Administration’s Plan to Lower Prescription Drug Prices Supports Biosimilar Competition, which will Decrease Drug Costs

WASHINGTON, D.C. – Today, the Department of Health and Human Services (HHS) released its Comprehensive Plan for Addressing High Drug Prices in response to President Biden’s Executive Order on Competition in the American Economy. We support the Biden Administration’s goal to lower drug prices for consumers and taxpayers by increasing biosimilar competition and minimizing disincentives.

“We thank HHS and President Biden for supporting biosimilars as a solution to the problem of rising prescription drug costs for millions of Americans,” said Meaghan R. Smith, Executive Director of the Biosimilars Forum. “This plan is an important step toward making lower-cost, life-saving biosimilars more accessible to patients who rely on them.”

Key policies the plan supports that would incentive biosimilars include increasing the add-on fee physicians receive when prescribing a biosimilar from 6% over the Average Sales Price (ASP) to 8%, and sharing savings with physicians who prescribe biosimilars under Medicare Part B. Together, these measures would encourage physicians to prescribe lower-cost, effective biosimilars to more patients who need them.

However, the plan’s support for a Medicare coding practice that “blends” Healthcare Common Procedure Coding System (HCPCS) codes for biosimilars and reference biologics would disincentivize biosimilars by diminishing cost savings and stifling competition. Instead of blended codes, every biosimilar should continue to be assigned a unique code and payment rate that reflects the complexity and savings potential of biosimilars.

Momentum on Capitol Hill and in the Biden Administration has been building this year in support of biosimilars. Several months ago, President Biden issued an Executive Order directing HHS to take steps to promote biosimilar competition, resulting in the report released today. The President also called on Congress to lower prescription drug prices.

In the House of Representatives, Congressmen Kurt Schrader (D-OR) and Adam Kinzinger (R-IL) introduced H.R. 2815, the Bolstering Innovative Options to Save Immediately on Medicines (BIOSIM) Act, which would increase the add-on payment to ASP+8%. And in the Senate, Senators John Cornyn (R-TX) and Michael Bennet (D-CO) introduced S. 1427, the Increasing Access to Biosimilars Act, which would enhance physician reimbursement for prescribing biosimilars.

For more information on the Biosimilars Forum, visit biosimilarsforum.org.