Health Plan Group Puts Biosimilars On Its Roadmap of Needed Healthcare Reforms

The game plan that the Alliance of Community Health Plans (ACHP) put out last week for how to improve American healthcare over the next 10 years included mentions of telehealth, Medicare Advantage, “consumer-oriented transparency tool” — and biosimilars.

More precisely the report, titled “Health Care 2030: ACHP’s Roadmap to Reform” mentions reforming intellectual property laws used to block biosimilars from getting on the market and taking steps to promote FDA approvals of biosimilars.

In an interview with Managed Healthcare Executive, Michael Bagel, ACHP’s director of public policy, said the pay-for-delay tactics that drugmarkers use to keep biosimilars off the market result in higher prescription drug prices. Bagel pointed to three jurisdictions where changes would help get more biosimilars on the market.

Michael Bagel

• Federal Trade Commission taking steps to curtail anti-competitive practices, including pay-for-delay agreements.
• U.S. Patent and Trademark Office issuing fewer patents for changes to products that fall short of true innovation.
• FDA prioritizing approvals of biosimilars.

Bagel said all three steps need to be taken in concert. So far, the price differences between brand-name products and biosimilars has been about 20% to 30%. “Well, that’s a start,” said Bagel, while also noting that the full scope of savings from biosimilar won’t be realized till there are more biosimilars on the market to compete against brand-name products and to compete each other.

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The ACHP comprises many high-profile nonprofit health plans, including Harvard Pilgrim Health Care, Kaiser Permanente and Priority Health. Many of the member plans are owned by health systems.

Bagel said the pace of FDA approvals of biosimilars has slowed this year. So far, the agency has approved just two biosimilars in 2020, Hulio (adalimumab-fkjp), a biosimilar to Humira, and Nyvepria (pegfilgrastim-apgf), a biosimilar to Neulasta. Although COVID-19 treatments and vaccines have understandably preoccupied the agency this year, Bagel said the “FDA needs to prioritize biosimilars” if more products are to make it on the market and have the intended effect on drug prices.