Denver – U.S. Senators Michael Bennet (D-Colo.) and John Cornyn (R-Texas) introduced the Increasing Access to Biosimilars Act, which would direct the Department of Health and Human Services (HHS) to establish a shared savings demonstration project to increase access to biosimilar biological products under the Medicare program.
“The skyrocketing cost of prescription drugs was a problem in this country before the pandemic. Now, even more Americans have to choose between their life saving medications and putting food on the table, especially seniors, communities of color, and the millions of people living on fixed incomes who need their prescriptions to live,” said Bennet. “This legislation would increase patient access to lower-cost biosimilars, saving them and our health care system billions of dollars. I look forward to working with my colleagues on both sides of the aisle to move this legislation forward.”
"Texans who need life saving medication shouldn't have to pay through the nose when there are lower-cost alternatives," said Cornyn. "This bill would lower Texans’ out-of-pocket costs while creating savings for Medicare, and I'm proud to offer a bipartisan solution to help drive down the cost of prescription drugs."
“Biosimilars are just as safe and effective as brand name biologics, but cost one-third less. Unfortunately, misaligned incentives are preventing physicians and patients from using lower-cost biosimilars. Thanks to the leadership of Senator Bennet, this common-sense policy can fix this problem and generate health care savings by encouraging biosimilar use and is a win for taxpayers given brand name biologics make up the top ten most expensive drugs in Medicare Part B,” said Meaghan Smith, Executive Director of the Biosimilars Forum.
“The Increasing Access to Biosimilars Act would take a critical step toward enhancing patient access to biosimilars through the creation of a voluntary, shared savings demonstration program in Medicare Part B,” said Christine Simmon, Executive Director of the Biosimilars Council. “The Biosimilars Council thanks Senator Michael Bennet and Senator John Cornyn for introducing this innovative solution to encourage greater biosimilar adoption and use in the U.S.”
Currently, providers in Medicare Part B are reimbursed for administering biologic drugs, including biosimilars at average sales price (ASP) plus +6%, of which the federal government pays 80% and beneficiaries pay 20% coinsurance. This means providers are reimbursed at a higher rate for using higher-cost biologic products rather than lower-cost biosimilars. At the same time, Medicare beneficiaries are forced to pay higher copays on those brand name biologic products.
This legislation would direct HHS to establish a shared savings demonstration project to increase access to biosimilars in the Medicare Part B program. Under the demonstration, Medicare would provide an additional payment to providers for using lower-cost biosimilar products reflecting savings created in contrast to administering higher-cost reference biologic drug. Additionally, the Medicare can use a portion of those savings to reduce the beneficiary’s coinsurance payment. This would encourage physicians to prescribe less-expensive biosimilars increasing patient access to more affordable, life-saving drugs and lowering patient out-of-pocket costs.
Under the demonstration, Medicare would provide an additional payment to providers for using lower-cost biosimilar products that reflects the savings created in contrast to administering the higher-cost reference biological product. Additionally, the Medicare can use a portion of those savings to reduce the beneficiary’s coinsurance payment.
The Increasing Access to Biosimilar Act is supported by: The Biosimilars Forum, Association for Accessible Medicines (AAM), and the Biosimilars Council and Viatris.
The bill text is available HERE.