ICYMI: Trump Administration’s Joe Grogan Recognizes Need for Biosimilar Incentives to Help Lower Healthcare Costs

WASHINGTON, D.C. (November 11, 2019) – Last Friday, White House Domestic Policy Council Director Joe Grogan spoke to reporters about domestic policy decision-making at the White House, and specifically called out the bipartisan progress on biosimilars.

Grogan said, “Incentivizing biosimilars to get that industry moving a little bit better, to bring costs down to the biologics market [is among the great bipartisan work underway].” 

Biologics are currently the biggest driver of drug spending in the Medicare program. Biosimilars represent a bipartisan opportunity to save billions for patients and taxpayers and support a robust second generation of lower cost medicines. 

Grogan’s comments reference a series of recent bipartisan biosimilars legislation introduced in Congress, which are projected to save patients and the health care system at-large billions of dollars annually:

• Acting to Cancel Copays and Ensure Substantial Savings for Biosimilars (ACCESS) Act by Congressmen Scott Peters (D-CA), Pete King (R-NY) and Anthony Brindisi (D-NY). This bipartisan bill would waive patients’ out-of-pocket costs for biosimilars under Medicare Part B. A recent analysis showed that this can save up to $5.2 billion in taxpayer dollars over ten years and that seniors in Medicare can save as much as $3.3 billion in out-of-pocket costs over the same period.
• Bolstering Innovative Options to Save Immediately on Medicines (BIOSIM) Act by Congressmen Kurt Schrader (D-OR) and Greg Gianforte (R-MT) would enhance provider reimbursement by increasing the ASP add-on payment rate for biosimilars in Medicare Part B. An increased ASP add-on could reduce health care costs by as much as $8.2 billion over the next decade. A similar bill was part of the Senate Finance Package in July.
• Most recently, bipartisan introduction of legislation from Congressmen Paul Tonko (D-NY) and Bob Gibbs (R-OH) would direct the U.S. Department of Health & Human Services (HHS) to create a biosimilar access measure in the Centers for Medicare & Medicaid Services’ (CMS) Star Ratings Program. This measure will help Congress and the industry better understand the barriers that exist to access lower-cost biosimilars in the Medicare Advantage and Part D health plans, allowing for future reforms to the market.

Biosimilars are a recognized, bipartisan solution to lowering health care costs.

Currently, millions of Americans rely on costly biologic treatments for some of life’s most serious diseases, including cancer, rheumatoid arthritis, psoriasis, inflammatory bowel disease, and Crohn’s Disease. Yet, they are unaware or unable to access lower cost biosimilars. Even though biosimilars are FDA-approved, equally safe and effective. It’s critical this administration and Congress act to remove these barriers to access and increase use of these lower-cost medicines.

To learn more about these money-saving policies and the Biosimilars Forum, click here.