From the 2024 HVPA National Conference
Branden Lee, MD Student (The Johns Hopkins University School of Medicine), Anna Chien MD (Johns Hopkins Hospital, Department of Dermatology)
In 2009, the Biologics Price Competition and Innovation Act was passed and allowed for the approvals of biosimilar products that are comparably efficacious to FDA-licensed biologics. Utilizing 2017-2021 Medicaid and Medicare Part B and D data from Center for Medicaid and Medicare Services, we analyzed yearly expenditure characteristics on relevant dermatologic biologics. In particular, we evaluated the total number of claims, beneficiaries, and spending for rituximab, etanercept, adalimumab, and infliximab, which are four common biologics with FDA-approved biosimilars that treat a number of dermatologically-relevant conditions, such as pemphigus vulgaris and plaque psoriasis. We also analyzed Veterans Affairs National Acquisitions Center data for approximated wholesale acquisition costs and federal fee schedule prices for these drugs and their available biosimilars.
Following inflation-correction, net expenditures across all three insurers decreased $132.8 m for rituximab, $1.1b for infliximab, $50m for etanercept, and $480.2m for adalimumab. This corresponded to a consumer adjusted growth rate of -13.6%, -19.3%, -7%, and -16.8% respectively. Similarly, the number of Medicare Part D and Medicaid claims fell by 55% and 66% for adalimumab and 27% and 35% for etanercept, respectively. Medicare Part B, Part D, and Medicaid claims fell 55% (2019 to 2021), 22%, and 42% for rituximab and 11%, -12% (Medicare Part D claims grew), and 24% for infliximab. This equates to an aggregated reduction of 368,069 claims and >$1.7b in savings within four years.
These results demonstrate a substantial retraction of originator utilizations by prescribing physicians leading to reduced federal spending and lowered patient costs. While the financial advantage is clear, use of biosimilars should continue to be monitored to ensure they meet clinical efficacy and patient tolerability in real-world settings.