Biosimilars Forum Urges Congress to Support Free Market Competition and Lower Prescription Drug Prices for Patients by Reforming Pharmacy Benefit Managers

Biosimilars for Humira® could have save Medicare beneficiaries and taxpayers close to $3 billion in one year

Juliana M. Reed, executive director the Biosimilars Forum, released the following statement following a press conference by Senate Finance Committee Chair Ron Wyden, D-Ore., and Ranking Member Mike Crapo, R-Idaho. The two Senators urged their conferences to pass Pharmacy Benefit Manager (PBM) reform.

“PBMs stifle free market competition and force Americans to pay more for the prescription drugs they need. Shockingly, three PBMs control 80 percent of the pharmacy benefit marketplace. This monopolistic system hurts patients by denying them access to critical, lower-cost, safe and effective prescription drugs. PBMs are in desperate need of reform, and the Forum supports Senators Wyden and Crapo in urging Congress to pass comprehensive PBM reform. 

“The PBM Monopoly blocks patients from having access to lower-cost biosimilars. There is no better example than biosimilars for Humira®, the world’s bestselling drug. Humira® has risen 470% in price  since first introduced. Ten Humira® biosimilars have launched at prices up to 85% lower-cost than the brand biologic. However, PBMs prioritize profits over patients and favor the higher-cost high-rebate branded Humira® biologic by placing it on a preferable formulary tier relative to its lower-cost biosimilar alternatives.

“Multiple Humira® biosimilars have discounts of up to -85% compared to the brand drug, but the vast majority of Medicare patients do not have access to these lower-cost options. Out of nearly 63,000 potential Medicare beneficiary patients, fewer than 3,000 have received a lower-cost Humira®-referenced biosimilar. Based on the price difference of these treatments, Medicare beneficiaries and taxpayers have lost an annual savings of close to $3 billion for this one medicine alone in one year.

“Shockingly, a report found that Humira® biosimilar competition has occurred in less than 2% of the U.S. market, even as the list prices of Humira-referenced biosimilars are as much as 85% lower than that of Humira®. Biosimilars have the potential to save the U.S. health care system up to $133 billion, but only if patients can access them.

“Biosimilars are a commonsense, bipartisan solution to one of the most important challenges facing Americans. The Biosimilars Forum supports patient access to lower cost medicines through free market competition in the pharmaceutical industry. We stand ready to work with both sides of the aisle and the Administration to prioritize patients and provide more choices for lower-cost drugs. Otherwise, the cost-savings promise of biosimilars could be lost forever.

“It is time we put patients first.”

For more information on the Biosimilars Forum’s work to increase access to lower-cost biosimilars, visit biosimilarsforum.org.