“‘One of the ways to align these incentives would be for CMS, in particular the Center for Medicare & Medicaid Innovation, to launch a demonstration project, a shared savings program in Medicare Part B for biosimilars. This would reward physicians for increasing their utilization of biosimilars, which would both create that incentive for physicians and align that incentive with the desire of taxpayers to lower overall costs in the biologic spend category,’ [Alex Brill] said.”
“The establishment of a shared savings model has the potential to increase health care savings, biologic competition, and biosimilar utilization if implemented in Medicare Part B, according to Alex Brill, founder of Matrix Global Advisors (MGA) and a resident fellow at the American Enterprise Institute (AEI), who makes the case in a new research paper.”
Matrix Global Advisors (MGA) today released a new report, “Shared Savings Demonstration for Biosimilars in Medicare: An Opportunity to Promote Biologic Drug Competition,” by MGA founder and CEO Alex Brill. The report identifies a unique opportunity in Medicare Part B to boost biosimilar utilization through the establishment of a shared savings demonstration model administered by the Centers for Medicare & Medicaid Services Innovation Center.
Alex Brill was one of the panelists discussing his “commitment to expand biosimilar use in the United States and how physicians and government officials are looking to help.
“A new report from Matrix Global Advisors and the National Business Group on Health, sponsored by Boehringer Ingelheim, shows that employers could see substantial savings from biosimilars, but those savings won’t come without a concerted effort to encourage biosimilar use.”
This paper estimates the savings opportunity from biosimilars in the medical benefit of a large employer-sponsored health plan, using real-world claims data. This analysis illustrates the savings potential of biosimilars in the commercial market and highlights the important role of employer-sponsored plans in promoting biosimilar utilization.
“Peter B. Bach, MD, a well-known critic of high drug prices, along with Jennifer A. Ohn, MPH, Preston Atteberry, MD, and Mark Trusheim, MSc, first wrote in April that biosimilar competition is an economically inefficient way to achieve the goal of lower prices; the biosimilar environment is different than the one that exists in the generic marketplace for small-molecule drugs. These authors said, instead, that biosimilars are natural monopolies and as such need price regulation in order for them to succeed and for prices to come down.”
“Would legislators take the opportunity to redo some parts of the BPCIA, if they had the chance? Both [Alex] Brill and Hayes said while that, too, is theoretically possible—such as shortening the period of patent exclusivity or changing other aspects of the patent dance—the danger is that it would then get stuck in the quagmire of politics.”