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What you should know about biosimilars

What you should know about biosimilarsRapidly increasing healthcare costs will likely continue to impact employers for the foreseeable future. As a result, many employers are considering strategies to manage these costs, including rising prescription drug costs. The introduction of biosimilar drugs as an alternative to biologics may bring value to healthcare by offering cost savings and increasing employee access to necessary medications.

While biosimilars can potentially combat rising prescription drug costs, employers will need to learn more about them before considering how their health plans can accommodate these newer drugs. This article explores biosimilar drugs and ways employers can promote or manage their use.

What are biosimilars?

The European Medicines Agency defines a biosimilar as “a biological medicine highly similar to another already approved biological medicine.” It is produced from living organisms — humans, animals or microorganisms, meaning they aren’t created from synthesized chemicals. They are also not identical to their reference biological products (also known as the brand-name counterpart).

The differences between biologics and biosimilars can be confusing. Let’s break it down.

Biosimilars vs. biologics: what is the difference

Approved by the Food and Drug Administration, biosimilars are related to the reference drug, a previously FDA-approved biologic, but have no significant clinical differences. Compared with biologics, biosimilars have the same strength, dosage and potential side effects, and provide the same treatment benefits.

The FDA rigorously evaluates biosimilars to validate their efficacy, safety and quality, and has approved more than 40 so far; however, not all are commercially available. FDA-approved biosimilars include Alymsys, Fylnetra and Idacio, according to GoodRX Health.

Employer considerations for biosimilars

The Biosimilars Council estimates that by 2025, 1.2 million people will have access to more-affordable biologic medicines because of the availability of biosimilars. Its research data suggests that women, lower income and elderly individuals stand to benefit most from access to biosimilars. The organization reports that biosimilars will save the national healthcare system up to $183 billion by 2025.

Current legislation aims to increase competition and decrease prescription drug prices by enhancing education concerning biosimilar drugs. As biosimilar acceptance and uptake increase, employers should consider the following actions as they design their benefits plans:

  • discuss biosimilars with partners (e.g., carriers, advisors and pharmacy benefits managers);
  • advocate for full cost transparency on specialty drugs to keep tabs on drug spending trends;
  • review health plans and drug use patterns to identify savings opportunities;
  • encourage the inclusion of biosimilars on formularies;
  • understand how rebates can impact overall drug pricing; and
  • advise employees about prescription drugs as part of overall benefits education.

Regulations, along with new drug approvals, are always updating, so it’s important for employers to continually research how biosimilars can be incorporated into their health plans.

Biosimilars and prescription drug costs

Biologics account for much of specialty drug costs and are typically cited as a leading driver of rising prescription drug costs. As the potential for biosimilars continues to grow, more employers may consider promoting them to help realize cost savings in their health plans and offer less expensive drug alternatives to their employees.

Contact HANYS Benefit Services today or call 800.388.1963 to learn more about the latest prescription drug trends. Our team of experts is ready to help you explore your options as you design or modify your benefits plan.

This Benefits Insights is not intended to be exhaustive nor should any discussion or opinions be construed as professional advice. © 2023 Zywave, Inc. All rights reserved.

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