Biosimilars provide the same therapeutic benefits at much less cost than biologic medications, but a first-of-its-kind survey led by USC Leonard D. Schaeffer Center for Health Policy and Economics shows that commercial insurers either exclude or limit use in almost 20% of cases.
The study, published in the journal BioDrugs, was inspired by a market-driven mystery: In traditional pharmaceuticals, coverage exclusions are usually aimed at more expensive treatment options, but biosimilars come at a lower cost.
Although brand biologics and specialty medicines account for 3% of all prescriptions, they constitute 55% of all drug spending. Therefore, biosimilars have the potential to increase savings while reaching greater numbers of patients with diseases such as cancer and rheumatoid arthritis.
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