Biosimilars
Helping manufacturers realize biosimilar potential
Understanding the complex coverage, payment, and regulatory landscape is critical to the success of any biosimilar manufacturer. As your strategic partner, our experts can anticipate reimbursement hurdles and create targeted strategies that maximize patient access at every stage of the product lifecycle. We develop the coding and reimbursement tools necessary—including compliant education programs—to minimize payment barriers and increase providers’ understanding of your product, while our policy and reimbursement experts help manufacturers stay informed on legal and compliance issues.
Approval pathway
New coding and payment policy could stifle biosimilar innovation
In November 2015, the Centers for Medicare & Medicaid Services finalized a controversial Medicare payment rule for biosimilars: all biosimilars relative to the same reference product will share the same Healthcare Common Procedure Coding System code and payment rate, separate from the reference product. This creates a single, blended Medicare reimbursement rate for the biosimilars based on the average sales price of all biosimilars to a reference product
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Are biosimilars the new generics?
With a handful of biosimilar treatments already approved by the Food and Drug Administration — and dozens of others coming down the pipeline — biosimilars are poised to disrupt the drug industry in terms of both care and cost. “In the next 10 years, I think we're going to catch up to Europe and see approvals speed up,” said Dave Picard, vice president of biosimilars and injectables at AmerisourceBergen. “For patients with high-cost, high-touch diseases, I think that biosimilars entering the space will improve access and affordability.”
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