Biosimilars Forum Applauds the U.S. Senate Finance Committee for Holding PBMs Accountable for Prioritizing Profits over Patients
Juliana M. Reed, executive director the Biosimilars Forum, released the following statement about the United States Senate Finance Committee hearing “Pharmacy Benefit Managers (PBMs) and the Prescription Drug Supply Chain: Impact on Patients and Taxpayers.” At least eight lower-cost, FDA-approved Humira® (adalimumab) biosimilars are expected to become available to patients by the summer of 2023. Their launches will be consequential in determining the future success of the biosimilars market in the U.S. and could save patients and the U.S. healthcare system more than $5 billion dollars a year, if – and only if – patients can actually access these medications at affordable costs.
“The members of the Biosimilars Forum and I applaud the Senate Finance Committee for holding PBMs accountable for their opaque and anti-competitive pricing schemes that force higher prices on patients, while denying them access to the treatments they need.
“Biosimilars can save the health care system $133 billion by 2025 if they are fully available and accessible to the patients who need them. Unfortunately, PBMs often prevent patients from accessing these lower-cost, FDA-approved treatments by forcing biosimilar manufacturers to launch biosimilars with high list prices and high rebates to gain access on their formularies. PBMs have proven time and time again that they prioritize higher list prices with high rebates over making treatments more affordable and accessible for patients.
“PBMs must be willing to support free market competition and place biosimilars on formularies – as they are approved, including mid-year updates – in preferred positions without restrictions. Particularly, PBMs must prioritize patients over profits and backend rebates by placing biosimilars – especially Humira® (adalimumab) biosimilars – on formulary tiers that are affordable and unrestricted for patients.
“Even though biosimilar manufacturers would prefer to make treatments available to patients at a lower list price, they are often forced to meet PBM demands for higher rebates to gain formulary access. This has led to dual pricing structures that focus on the traditional higher price and high rebates compared to using lower list prices for patients. These PBM schemes thwart robust, transparent competition.
“PBM transparency is not enough. Lawmakers and regulators must ensure biosimilars have preferential placement on formularies as they become available. This would increase access to lower-cost biosimilars for patients, promote prescription drug affordability, and support health equity.”
For more information on the Biosimilars Forum’s work to increase access to lower-cost biosimilars, visit biosimilarsforum.org.