Ep 5- The Price and Hoops to Saving Money

When biosimilars were introduced into the US, there was much talk about how much money they could potentially save patients. Getting a biosimilar developed and approved by the US Food & Drug Administration (FDA) is not as rigorous or time-consuming as for a biologic … which was touted as being more economical. And insurance companies were supposed to pass along savings to consumers. In this episode, Zoe and Conner look at why that hasn’t happened to any large degree, and what can be done about it.

“I think there’s going to be a healthy competition on pricing that we haven’t had until now,” says Dr. Simon Helfgott, rheumatologist at Brigham & Women’s Hospital in Boston.

Among the highlights in this episode:

2:40 – Why the big savings haven’t materialized

4:25 – What happens when insurance companies arbitrarily change biosimilar coverage

5:21 – Options available to patients

7:03 – How competition could ultimately help consumers

8:49 – Pharmacy benefit managers, and why they don’t benefit patients

11:00 – Rebate contracting, and how it keeps the market share for biosimilars low

12:24 – The good news: Slightly more aggressive pricing structures, and lower costs for some employees

Contact Our Hosts:

Zoe Rothblatt, Patient Advocate and Community Outreach Manager at GHLF. [e-mail]

Conner Mertens, Patient Advocate and Community Outreach Manager at GHLF. [e-mail]

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