Mar 14, 2023 | Posted in Clinical

Biosimilars: The answer to rising healthcare costs?

In an industry beset by escalating healthcare costs, modern patients are constantly seeking novel strategies to reduce their care spend, particularly for prescription medications. Today, few developments have had as large an impact on both the cost and accessibility of medicine as the emergence of biosimilar drugs. What are biosimilars? Let’s review.

What Are Biologic Pharmaceuticals?
Traditionally, the vast majority of pharmaceuticals were synthesized from chemical compounds with well-defined chemical structures. But, in recent decades, biological products have revolutionized how we treat many different types of diseases.

As the name suggests, biologics are derived from living cells and organisms, such as bacteria, animal cells, or yeast. Because of this, the manufacturing and design of a biologic tends to be more complex, seeing as developers are working with large and complex molecules like proteins, nucleic acids, or sugars.

Biologics are used to treat a wide range of diseases—such as genetic disorders, autoimmune disorders, and some cancers—many of which previously had no or limited treatment options. Examples of biologic products include:

● Vaccines
● Monoclonal antibodies
● Cell therapies
● Gene therapies

A biosimilar drug is a biologic pharmaceutical product that has been FDA-approved based on its similarity to an existing FDA-approved reference product, and which has no clinically meaningful differences in safety and efficacy.

Most people are familiar with generic drugs, which are typically a carbon copy of the brand name pharmaceutical. These often work the same exact way as the brand drug, but tend to be cheaper. As the American Cancer Society notes, making a generic drug is possible because:

“The active ingredients in drugs are made from chemicals that have a specific structure that can be copied. However, a biologic comes from a biologic (natural) source that cannot be copied exactly. These medicines come from very complex, living systems whose environments can change.”

Put simply, biologics are too complex and large to make an identical version. And they’re grown rather than synthesized.

That said, a biosimilar is designed to be as similar as possible to the reference biologic drug, but will not be an exact copy. They may be able to treat the same disease, but will first need to undergo a more rigorous FDA approval process before they can be classified as interchangeable.

Biosimilars vs. Generics
So how do biosimilars compare to generics?

1. Reduced cost – Like generics, biosimilars tend to be less expensive than the reference biologic, making them more affordable and accessible. Rand Corporation estimates that biosimilars may lead to savings of up to $150 billion in direct spending between 2017 and 2026.

2. Expanded treatment options – Biosimilars enhance the availability of pharmacogenetic treatment options, empowering care providers to tailor treatments to the patient’s genetic profile and budget.

3. Improved care outcomes – Increased access to biologics can lead to improved patient health outcomes while also creating efficiencies in the healthcare system.

Biosimilars with BeneCard PBF
Biosimilars have the potential to upend the care system, benefiting patients and providers alike by increasing access to care, reducing costs, improving the quality of life for patients, and creating competition and innovation within the life science industry. And, as technology and medical research continue to evolve, even more biosimilars are primed to hit the market over the next decade.

As a pharmacy benefit manager, BeneCard PBF seeks to pair patients with the most effective, lowest-cost medicines available, including biosimilars. We believe in taking a pharmacogenetic approach by tailoring pharmaceuticals to the patient, their condition, needs, and budget.

How does the PBM model work?

If you want to learn more about our care approach, let’s talk.


Pfizer. Let’s Take A Closer Look At The Characteristics Of Biosimilars What Are Biosimilar Drugs?

Rand Corporation. Biosimilar Cost Savings in the United States

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