Reports and Surveys | April 13, 2020

Employer Strategies for Use of Biosimilar Pharmaceuticals

Employers have a relatively new instrument in their drug-management toolkit: biosimilars.

Mirroring the use of generic drugs for brand-name non-biologic drugs, biosimilars have the promise of being less expensive alternatives to their biologic brand-name counterparts.

This is good news for employers, since biologics make up the majority of specialty drug costs and are a leading driver of overall rising prescription drug cost trends for most employers.

This paper introduces biosimilars, the market challenges facing them and the strategies employers can follow to increase their use or help manage ongoing utilization.

Get the Publication

Scientists Working In The Laboratory Download Now

What you'll learn from this report

Were you aware that biosimilar drugs are generally 15 to 20 percent less expensive than their biologic counterparts, and some may be as much as 30 percent less?

In this report, prepared for the ERISA Industry Committee (ERIC), we explore the biosimilar landscape as it applies to health benefit coverage. 

You'll learn about:

  • The background on biosimilar manufacture
  • The employer’s role in promoting biosimilars
  • Increasing understanding of biosimilars by health plan participants and health care providers
  • Adopting clinical management programs
  • Designing the payment features of prescription drug benefits
  • Addressing biosimilar drugs when negotiating PBM contracts
  • The biosimilar pipeline

Learn more about biosimilar cost management strategies. Get in touch.

Contact Us

Putting the biosimilar pieces together

While utilization of the handful of available biosimilars is currently low, there is positive movement towards the growth of these drugs.

Although biosimilars are still an emerging drug option, they offer another way for employers to offer high-quality, affordable drug options to their health plan participants.

Employers interested in fully exploring the benefits of offering these drugs to medical and pharmacy plan participants should work with their partners and benefit advisors, develop a go-forward prescription drug strategy including biosimilars and make efforts towards creating awareness of these drug options.

Work with partners

Employers should work with their PBMs, health plan carriers, pharmacy benefit consultants and legal counsel to understand the ongoing evolution of the biosimilar market and monitor the pipeline of new biosimilar drugs.

It is also important for employers to identify which PBMs are promoting greater use of biosimilar drugs and include biosimilar provisions and competitive payment features in their PBM contracts.

For example, as modifications are made to how biosimilars are administered or where they are administered, there may be savings opportunities for employers.

Develop a strategy

Employers interested in exploring the cost-savings potential of biosimilars should include them in their pharmacy benefit strategy. There are numerous clinical management strategies employers can take to improve the quality of care offered to plan participants while also lowering costs.

Create awareness

It is not too early to increase awareness of biosimilars through communication campaigns aimed at plan participants and health care providers.

Additionally, it may be helpful to consider how PBMs and health plan carriers will handle newly launched biosimilars. Some PBMs are already making strides by promoting select biosimilars on their formularies.

Questions about biosimilars? We have answers.

Get in touch. We'd be happy to help. 

Contact

See more insights on health

Doctor Giving A Senior Woman A Vaccination

Additional Federal COVID-19 Guidance on Testing and Vaccines

Review the coverage of diagnostic testing and vaccines to ensure your benefits are being provided consistent with this federal guidance
Young Couple Going Through Their Paperwork Together At Home

Guidance on Extended Deadlines for Group Health Plans

Learn more about the new guidance and COVID-19 relief extension for group health plans.
Mother And Child At A Paediatrician Appointment

COBRA Subsidy Passes House

Learn more about the COBRA provision of the American Rescue Plan Act of 2021.

This page is for informational purposes only and does not constitute legal, tax or investment advice. You are encouraged to discuss the issues raised here with your legal, tax and other advisors before determining how the issues apply to your specific situations.

Don't miss out. Join 16,000 others who already get the latest insights from Segal.