2020 Spend and Trend Report Shows Biosimilar Competition Led to Decreases in Originator Prices, Claims

Despite a slow increase in uptake since the first biosimilar entered the US market in 2015, biosimilars are on track to gain a meaningful place in the market, especially as more competitors for one reference product are launched, according to Artemetrx’s spend and trend report for 2020.

In the report, the authors examined market trends for several biosimilars on the US market, many of which are indicated for use in the oncology and rheumatology spaces, from 2018 to March 2021. The report covers how biosimilars have impacted the prices and claims for reference drugs. The authors also estimated the potential savings that plan sponsors could generate depending on how much of their patient populations are switched to biosimilar versions from originators.

The percentage of total claims for originators drugs that are facing biosimilar competition declined significantly between 2019 and 2020. For example, biosimilar claims for pegfilgrastim and trastuzumab now make up 34% and about 40% of all claims for each molecule, respectively.

The authors stressed that they anticipate increased market competition will lead to lower prices for both originator and biosimilar products. “Beyond the cost savings directly created by the increased use of biosimilars, the impact of their presence in the market is seen in the price pressure put on [reference] drugs,” they wrote.

Biosimilars for reference infliximab (Remicade), which include Inflectra (infliximab-dyyb), Renflexis (infliximab-abda), and Avsola (infliximab-axxq), only represented about 18% of all infliximab claims in 2020. However, they had a greater impact on the average sales price (ASP) of the reference product, which decreased from nearly $75 per unit to $45 per unit between January 2019 and December 2020.

Similar patterns were observed for pegfilgrastim products, with claims for the originator (Neulasta) dropping to 66% because of the rapid uptake of biosimilars. The ASP per unit for Neulasta fell from $4500 in January 2019, when only 1 biosimilar was on the market (Fulphila, pegfilgrastim-jmdb), to $3500 in December 2020, after 2 other biosimilars entered the market (Udenyca, pegfilgrastim-cbqv; Ziextenzo, pegfilgrastim-bmez).

Biosimilars for reference bevacizumab (Avastin), rituximab (Rituxan), and trastuzumab (Herceptin) are relatively recent additions to the market and have contributed to gradual decreases in ASP per unit for the originators. Avastin and Rituxan each face competition from 2 biosimilars and Herceptin is competing with 3 biosimilars.

The authors developed models to estimate how much plan sponsors could save annually by switching patients from Remicade and Neulasta to biosimilar versions.

A moderate shift entailing switching 20% of every 100 members to biosimilar infliximab would save plan sponsors $87,780 annually. An aggressive shift, where 50% of every 100 members would be switched, would save plan sponsors $219,450 annually. A moderate shift from Remicade to biosimilar versions would produce $199,460 in savings annually, and an aggressive shift would save 498,650 annually.

The authors said that rebates need to be bigger consideration among plan sponsors as more biosimilars enter the market. Currently, Remicade averages $9 in rebate per unit, similar to the rebates for Inflectra and Renflexis but slightly higher than Avsola’s $6 average rebate per unit. However, for pegfilgrastim products, Neulasta’s average rebate is substantially higher than biosimilars, coming in at $431 per unit compared to a range of $19 to $70 per unit for biosimilars.

Reference

State of Specialty Spend and Trend Report. PSG Consults website. https://www.psgconsults.com/specialtyreport. Published August 12, 2021. Accessed August 11, 2021.