Biosimilars Forum Calls for Reform of the PBM Monopoly

The PBM monopoly stifles free market competition and forces Americans to pay more for the prescription drugs they need

Juliana M. Reed, executive director the Biosimilars Forum, released the following statement in response to the Federal Trade Commission’s interim report that found that six major pharmacy benefit managers (PBMs) filled 95 percent of all prescriptions in the U.S.

“PBMs are in desperate need of reform. PBMs actively block patients from being able to access lower-cost biosimilars by favoring drugs that pay the PBMs high rebates in exchange for guaranteed market share. This monopolistic system hurts patients by denying them access to lower-cost, safe and effective prescription drugs.

“The FTC interim report importantly notes that PBMs exclude generic drugs and biosimilars from formularies in exchange for higher rebates paid to PBMs. These exclusionary schemes cut off patient access to lower-cost medicines. These unethical businesses practices should be investigated and reformed by the FTC, policymakers, and industry stakeholders.

“It is time the policymakers and industry put patients first. Patients must have complete and easy access to lower-cost, FDA-approved biosimilars. To accomplish this, we need comprehensive reform of the PBM monopoly now. Small and incremental change is not enough.

“Biosimilar manufacturers are doing their part to bring lower-cost products to market. Unfortunately, PBMs have denied patients access to these lower-cost options.

“Biosimilars are the answer to skyrocketing prescription drug prices. Biosimilars can save the U.S. health care system up to $133 billion if they are accessible. A recent IQVIA report discovered that adalimumab biosimilars could have offered savings of up to $6 billion to the U.S. health care system if they had formulary access. Medicare could have saved an estimated $2.19 billion on Humira over four years had biosimilar competition been available. Yet these cost-savings are being completely left on the table because PBMs have prioritized access to their formularies for high cost, high rebate drugs over patients and lower-cost biosimilars.

“Biosimilars are a commonsense, bipartisan solution to one of the most important challenges facing Americans. The Biosimilars Forum supports 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.”

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