According to an article published in Reuters, seven new biosimilars that offer the same benefits as the arthritis drug adalimumab—but at more affordable prices—may lead to further criticism of pharmacy benefit managers. Since the passage of the Inflation Reduction Act in 2022, lawmakers and the Federal Trade Commission have investigated the role of pharmacy benefit managers in the rising cost of health care. Although three of the new adalimumab biosimilars will be priced within 5% to 7% of the reference product, two others will be priced at an 85% discount—and the remaining two will offer both options for pricing. Historically, once biosimilars are available, prices overall tend to plummet, and recent analyses have shown that traditional generic drugs that are exact copies of name-brand drugs and biosimilars tend to reduce prices by 90% and 50%, respectively. However, experts stressed that savings have been minimal for insured patients who are required to make copays at 10% to 25% of the list prices. Lawmakers are currently drafting several bills that would require pharmacy benefit managers to disclose their business dealings to the public—including the fees they earn on transactions—and report payments to the Federal Trade Commission that they receive from health plans along with the fees they charge to pharmacies. The experts noted that it may take time for these measures to result in savings for patients and advised that stricter operational rules may be needed to ultimately lower the cost of drugs. “That list prices of [adalimumab] and its biosimilars remain high even with robust competition should fuel calls to reform our … dysfunctional pharmaceutical supply chain,” concluded Ameet Sarpatwari, PhD, JD, Professor of Medicine at Harvard Medical School.
August 03, 2023