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Reimbursement is just one of the issues facing biosimilar commercialization in the US
In conjunction with the Academy of Managed Care Pharmacy (AMCP) Managed Care & Specialty Pharmacy Annual Meeting (Denver, March 27-30), Amgen has released the fourth edition of its Trends in Biosimilars Report. The study is a useful compilation of recent research and studies on commercialization and distribution issues but, aside from statements from its editorial board members, does not present new survey data.
One of the surprising findings in the report (based on earlier research by the firm Avalere Health) is that, for Medicare patients still in the coverage gap between when full coverage under Medicare Part D kicks in, a biosimilar product can cost the patient more out-of-pocket than the originator drug. The reason: biosimilars are lumped together with generics in Medicare reimbursement policy, which have a less generous schedule for coverage.
Other commercial challenges:
The Amgen report is available here.