Cassandra Habura

As attention on the management of biologic agents increases, payers anticipate the first biosimilar entrant into the US market.

	Attention to biosimilars within the United States has been gaining momentum as their utilization in Europe continues to grow. In the Spring 2013 Managed Care Biologics and Injectables Index, payers continue to anticipate biosimilars impacting specialty category management within 2 years. This is in line with the Fitch Ratings report estimates, which predict the first biosimilar entrant into the United States market in 2015 (www.reuters.com/article/2013/06/27/fitch-patent-expirations-drive-growth-

	gl-idUSFit66125520130627). As the introduction of these agents into the marketplace looms nearer, stakeholders prepare, remaining focused on approval pathways of the agents, interchangeability, and discounts.

	Payer perception regarding discount and impact shifted slightly over the past year. Data from the Spring 2013 Managed Care Biologics and Injectables Index shows that payers anticipate the net savings from biosimilars agents to be above 12%, representing a 2.4% increase from spring 2012.

	Although focused on the discounting and savings that biosimilars will offer, payers must also anticipate their implementation of utilization tools in biosimilars management. Nearly half of payers note they will utilize the prior authorization and step therapy required for the branded reference product for a biosimilar that has comparable efficacy and safety, is not an interchangeable, and provides adequate net savings.

	Biologics are complex and pricey agents. The advent of biosimilars will only add to the complexity. As the biologics landscape continues to evolve and biosimilars begin to make their entry, there is no doubt that payers will focus heightened attention on the management of these agents. 

Cassandra Habura is a senior analyst, syndicated research, at Zitter Health Insights.

Cassandra Habura

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