Juliana Reed, MS: Addressing Anti-Competitive Behaviors of Pharmacy Benefit Managers

In part 2 of HCPLive’s interview with Juliana Reed, MS, executive director of the Biosimilars Forum, discussed the implications of the recent United States Senate Finance Committee hearing regarding biosimilars, and how it may impact patients and taxpayers.

“I think it's a start,” Reed stated. “I think that if the hearing and if Senate Finance looks to policy changes, that could have a real change on cost for consumers, taxpayers, and patients. But the action cannot be stopped at just transparency. Transparency will only show us what we already know: that there's a problem.”

She argued, instead, that there needs to be action that addresses the anti-competitive behaviors of pharmacy benefit managers (PBMs) and provides access to all biosimilars. The Senate and House hearings should push the Federal Trade Commission to investigate both the biosimilar issues and the anti-competitive behaviors of PBMs.

Reed believes that if PBMs were required to place all biosimilars on a formulary and allow competition to happen, then the biosimilar market would not only be successful, but it would also encourage further investment. The ultimate goal of passing the law for biosimilars was to create competition that would lower costs for patients and taxpayers, which won't happen if PBMs limit the marketplace. Therefore, the Senate and House should focus on investigating PBMs' anti-competitive policies and actions to ensure that access and competition are provided.

The United States is a bit slower to accept biosimilars compared with other countries, due in part to the actions of PBMs.

“The lack of government support is also a factor,” Reed explained. “In Europe, countries have saved money by using biosimilars. Medicare and other government programs should also prefer lower cost biosimilars. However, PBMs control 80% of the commercial market, and employers are angry that they're not giving access to biosimilars.”

IQVIA is predicting $133 billion in savings in the next 3 to 5 years, and Medicare found that they could have saved $2 billion by converting only a small number of patients to biosimilars.

“Despite investing time and money into developing biosimilars, uptake has been low due to market failure,” Reed concluded. “Overall, everyone could do a better job of supporting biosimilar uptake.”

This transcript was edited for clarity.