ROBERT KING March 19, 2019
Insurers
must be willing to take a short-term financial loss to get long-term savings
from adopting biosimilars, outgoing Food and Drug Administration Commissioner
Scott Gottlieb said Tuesday.
There are
major commercial obstacles to getting biosimilars onto the market to replace
pricey biologics, Gottlieb said at a Brookings Institution event. Even though
the FDA has approved 16 biosimilars, very few are on the market. Gottlieb will leave his post as
commissioner early next month to spend more time with his family.
"It
hasn't surprised me that (the biosimilar market) has been slow to
develop," he said.
Biosimilars
have the chance to generate tremendous savings for health plans, studies show.
A 2017 study from the
RAND Corp. estimated that biosimilars could lower spending on biologic drugs by
$54 billion from 2017 to 2026.
Traditionally,
biologic-drug makers offer rebates to insurers and will increase that amount
when a biosimilar is about to hit the market.
"If
you are a health plan and you adopt a biosimilar onto your formulary you lose
all the rebates," he said.
To offset
the loss of the rebate, the insurance plan needs to sell enough of the
biosimilar. But it can be difficult to get patients to switch to the cheaper
drug, the commissioner noted, and that could be in part because physicians are
resistant to prescribing biosimilars.
Gottlieb
believes this resistance will erode over time as more biosimilars are approved
to handle chronic conditions.
But an insurance
plan should move toward biosimilars because of long-term savings to their drug
spending, he said.
"If
they put the biosimilar on a formulary they might lose money for a quarter when
they lose the rebates, but if they can convert their population over a two-year
period to the biosimilar they will create a lot of competition that is going to
lower their drug spend," Gottlieb added.
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