The Biosimilars Forum Applauds the FTC for Requiring PBMs to Increase Transparency and Lower Prescription Drug Prices

Juliana M. Reed, executive director of the Biosimilars Forum, released the following statement following an announcement by the Federal Trade Commission (FTC) about an enforcement action against Express Scripts, as well as Caremark Rx and OptumRx, alleging that the Pharmacy Benefit Managers (PBMs) created a system that artificially drove up the list prices of drugs by preferencing rebates.

“The Biosimilars Forum commends the FTC for securing a landmark settlement to lower prescription drug costs for Americans. The settlement requires one of the nation’s largest PBMs to adopt fundamental changes to its business practices that increase transparency and lower the cost of prescription drugs for patients.  

“This settlement will end PBM business practices that have kept drug prices high and could lower patients’ out-of-pocket costs for drugs like insulin by up to $7 billion over 10 years. PBMs have prioritized profits over patients for too long, and this settlement is a key step in helping Americans afford the medicines they need.

“For too long, PBMs determined the success of prescription drugs by prioritizing high cost, high rebate products. There is no better example than biosimilars for Humira®, the world’s bestselling drug. Humira® has risen 470% in price  since first introduced. As Humira® biosimilars launched at prices up to 85% lower-cost than the brand biologic, PBMs favored the higher-cost high-rebate branded Humira® biologic by placing it on a preferable formulary tier relative to its lower-cost biosimilar alternatives. A recent found that Humira^® biosimilar competition still has less than 13% of the U.S. market, costing patients and the government billions of dollars.

“Nearly 30% of Americans say they have not taken their medication as prescribed due to unaffordable prices. FDA-approved biosimilars are on average more than 50% lower-cost than the originator biologics they reference. Biosimilars are a key component of the solution to fix America’s healthcare affordability crisis. 

“In the past eight years, the U.S. healthcare system saved $56 billion from biosimilars. Remarkably, biosimilars have the potential to save the U.S. health care system – including Medicare and veteran healthcare – up to $181 billion over the next five years. 

“This is especially pertinent as a ‘biosimilar void’ comes into view. Over the next decade, 118 biologics are expected to lose patent protection, and biosimilars could offer significant cost-savings for each of these. Unfortunately, only 10 percent currently have biosimilars in development, while 90 percent have no biosimilar in the pipeline.

“This is an outstanding step forward in helping Americans access lower-cost biosimilars, and the Forum looks forward to continuing to work with the Trump Administration, the FDA, and members of Congress.”

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

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