Biosimilar Introduction Reduces Biologic Prices in the US and Globally

The price of biologics both globally and in the US significantly reduced following the introduction of biosimilars, a study found.¹

Prior research showed biologics prices reduced after introducing biosimilars in the market.² However, the studies analyzed this with insurance claims data, failing to show negotiations and discounts between healthcare providers and insurers. The new study, led by Hui-Han Chen, MHS, BS, from the UNC Eshelman School of Pharmacy at the University of North Carolina, used annual global sales in the IQVIA MIDAS® database to examine the price fluctuations after introducing biosimilars.¹

“This analysis showed that the entry of biosimilars impacted the biologics price through both instant reductions and changes in long-term price trends,” wrote investigators. “Three of the eight biologics (i.e., bevacizumab, infliximab, and trastuzumab) had a significant instant reduction in price.”

Investigators aimed to assess how the introduction of biosimilars impacted the price of 8 biologic products—adalimumab, bevacizumab, epoetin, etanercept, filgrastim, infliximab, pegfilgrastim, and trastuzumab—in 57 countries and regions.

Countries and Regions

Argentina
Australia
Austria
Belarus
Belgium
Bosnia
Brazil
Bulgaria
Canada
Chile
Colombia
Croatia
Egypt
Estonia
Finland
France
Germany
Greece
Hungary
India
Indonesia
Ireland
Italy
Japan
Kazakhstan
Korea
Latvia
Lebanon
Lithuania
Luxembourg
Malaysia
Mexico
Morocco
Netherlands
Norway
Pakistan
Peru
Philippines
Poland
Portugal
Romania
Russia
Serbia
Singapore
Slovakia
Slovenia
Spain
Sweden
Switzerland
Taiwan
Thailand
Tunisia
Turkey
United Arab Emirates
United Kingdom
United States of America
Vietnam

The team analyzed prices of biologic products from January 1, 2012, to December 31, 2019, using an interrupted time series design series. After biosimilar introductions, they examined the immediate and long-term changes in biologics ex-manufacturer pricing.

Investigators began by identifying the standardized dose of each biologic based on what dose appeared more frequently in the database. After that, they standardized the medicine price to the most used dosage of the biologic.

The team saw infliximab was the most available in biosimilar forms compared to the other 7 biologics. The biosimilar infliximab was available in 43 countries and regions and had a median market entry date in 2015. In contrast, bevacizumab had the lowest availability and in 2019 the biosimilar was only on the market in 7 countries.

Investigators observed an increase in consumption of both biologics and biosimilars sold each year across adalimumab, bevacizumab, epoetin, etanercept, infliximab, and pegfilgrastim. One year after biosimilars became commercially available, the total doses of biologics and biosimilars increased by 16.3% for adalimumab, 29.7% for bevacizumab, 10.8% for epoetin, 7.3% for etanercept, 6.8% for infliximab, and 7.0% for pegfilgrastim. However, the consumption of filgrastim and trastuzumab decreased by 7.2% and 3.4%, respectively.

Furthermore, they noted a lower demand for biologics with a decrease of 19.8% for adalimumab, 9.6% for epoetin, 14.8% for etanercept, 20.0% for filgrastim, 1.3% for infliximab, 13.8% for pegfilgrastim, and 17.8% for trastuzumab. The only biologic that did not have a lower demand was bevacizumab, which increased by 6.5%.

As for biosimilars sold, the proportion was 5.7% for adalimumab, 0.4% for bevacizumab, 3.0% for epoetin, 15.9% for etanercept, 15.1% for filgrastim, 13.5% for infliximab, 3.2% for pegfilgrastim, and 2.3% for trastuzumab.

Once biosimilars hit the market, a biologic product’s average price per dose dropped by $438 for trastuzumab, $112 for infliximab, and $110 for bevacizumab. Further price reductions occurred yearly, with decreases of $49 for adalimumab, $290 for filgrastim, $21 for infliximab, and $189 for trastuzumab.

Investigators also analyzed how biosimilars impacted the prices of 4 biologics in the US. They found 3 biologics in the US significantly reduced every year, reducing by $955 for filgrastim, $753 for pegfilgrastim, and $104 for infliximab.

The team outlined multiple limitations: only evaluating prices paid by wholesalers or distributors but not patients, not controlling for personal demographics like age, and not analyzing data from all countries and all biosimilars. They also noted unobserved time-variant confounders may impact the results.

“These findings not only demonstrate the economic benefits of increasing biosimilar utilization but also emphasize the importance of biosimilars in controlling healthcare costs,” investigators wrote. “Policies should aim to expand the availability of biosimilars to counteract the exponential growth of medical spending caused by the use of biologics.”