If the U.S. government revised its current Medicare Part B reimbursement policy for biosimilar drugs, it could save $11.4 billion over the next 10 years, according to a new report.
This finding is from “The Fiscal Implications of Discrete Codes for Biosimilars” analysis, conducted by The Moran Company for the Association for Accessible Medicines (AAM) and its Biosimilars Council. The report states that that the Centers for Medicare and Medicaid Services’ (CMS) current reimbursement policy on biosimilar medicines could produce short-term savings, but at the expense of larger, long-term savings for Medicare.
“Additionally, in Part B, CMS has chosen to create a coding and reimbursement structure that deeply disincentivizes development of biosimilars …This policy could significantly limit biosimilar adoption in outpatient settings, which would create a significant barrier to entry for any potential biosimilar competitors,” said Chester “Chip” Davis, Jr., President and CEO of AAM, in a statement before the Senate Health, Education, Labor and Pensions Committee in mid-October.
However, Robert Goldberg, PhD, Cofounder and Vice President of the Center for Medicine in the Public Interest, does not agree with the report’s projected cost savings on biosimilars if the CMS policy were to be revised.