New MGA Analysis of Biosimilar Coverage in Commercial Medical Benefit

A new MGA white paper from CEO Alex Brill and Principal Christy Robinson shows a positive outlook for biosimilar coverage in the commercial medical benefit.

While patients and physicians play a role in the utilization of these lower-cost alternatives to reference biologic drugs, health insurance plans are an important driver of biosimilar adoption. To shed light on recent trends in payer coverage of biosimilars, the new MGA paper analyzes commercial medical benefit coverage and price trends for biosimilars and reference biologics over the period 2018–2021 in three disease areas: breast cancer and non-small cell lung cancer (NSCLC), colorectal cancer and chronic lymphocytic leukemia (CLL), and neutropenia (a side effect of chemotherapy).

The analysis shows that medical benefit coverage for biosimilars in these disease areas increased and prices declined during the period studied. Additionally, the share of preferentially covered biosimilars more than tripled.

Click here to read the full paper.