Biosimilar medicines, a nearly identical copy of an original biologic treatment, have recently taken center stage in the pharma industry. As approvals and implementation of biosimilar products, therapies, and medicines continue to accelerate, the U.S. healthcare system is set to experience enormous cost cuts and save Americans millions of dollars in life-essential care. The rise of the COVID-19 pandemic in April 2019 ushered in a historic wave of 58 approvals by the European Medicines Agency, and activity in biosimilar production hasn’t slowed since.
The financial burden of manufacturing biological medicines involves using cutting-edge technologies to extract large complex molecules derived from living cells–a challenging and expensive process. On the other hand, biosimilar manufacturing relies on replicating the amino acid sequences of its reference drug, leaving a small window for minor differences and eliminating the costs and lead time for FDA approval.
Already, pharma investors are reaping the financial benefits of pouring capital into the cost-effective alternative. For biological medicines, studies have revealed research and development costs at $985 million to bring a single product to market. In addition, patients experience the financial brunt, paying on average between $10,000—$30,000 per year for some treatments, with some reaching millions of dollars, according to the National Conference of State Legislature.
Contrarily, biosimilars have list prices 15% to 35% lower than their reference products, saving individuals $8 billion in 2020 alone. As patents expire and new biosimilar products are introduced, savings in 2022 are projected to surpass $30 billion and drive price competition within the pharma industry.
As biosimilars simultaneously shrink healthcare expenditures and rake in investment capital, we took a deep dive into this lucrative industry trend. In the AlphaSense platform, there has been an 11% increase over the last six months of documentation around “biosimilars”. Below, we look at how the Inflation Reduction Act plays into the biosimilars market and what C-Suite leadership from major pharma companies and industry experts are saying.
The Inflation Reduction Act
This past October, biosimilar drug-pricing provisions associated with the Inflation Reduction Act went into effect. Over the next five years, Medicare is expected to financially cover physician-administered biosimilars at an ASP plus 8% rate to foster patient and medical professional consumption.
Prior to the Act, Medicare paid the average sales price plus 6% for a biosimilar product and separately payable drugs—the average sales price consists of the manufacturers’ sales to U.S. purchasers, excluding rebates, discounts, and price concessions. Consequently, the Act drives biosimilar production to develop biological product competition and lower healthcare costs.
But the Centers for Medicare and Medicaid Services (CMS) believe that Medicare’s temporary coverage increase will drive much more than just competition between biologic and biosimilar products.
In a statement, CMS Administrator Chiquita Brooks-LaSure shared that it “will foster competition in the drug marketplace for conditions such as diabetes, cancer, and immune disorders.” Since the slow introduction of biosimilars between 2015 and 2018, corresponding therapy uptake has increased so much that originator biologic market shares in the trastuzumab, rituximab, and bevacizumab classes have depreciated.
The top ten Part B drugs expended to Medicare through the buy-and-bill process are all biologics that do not have biosimilar counterparts. However, the Inflation Reduction Act is not the only motivator behind the adoption of biosimilars. Research has revealed growing trust among physicians and patients alike with biosimilars thanks to education campaigns and improved regulatory guidance from the Food and Drug Administration.
“As the latest government policy projected to inject competition among biologics, add-on payments for biosimilars may produce additional modest gains in market share by these products,” Forbes analyst Joshua Cohen writes.
The Outlook on Biosimilars
Equity research found within the AlphaSense platform aligns with predictions proposed by industry experts. The biosimilar market size will grow by an increasing number of biological losses of exclusivity (LOE). LOE describes the transition period when once a drug’s patent expires, the manufacturer must relinquish control of the drug formula, allowing manufacturers to produce biosimilars.
As more biosimilars enter the market, analysts see the potential for a greater drug channel split between medical vs. pharmacy benefits. Physicians are likely to prescribe more biosimilars with increasing widespread acceptance and integration. And with increases in biosimilar uptake, additional therapeutic areas will likely advance, focusing on retina diseases, bone health, G.I., and derm and, consequently, increase the cost of biosimilar development.
These industry predictions are leaving pharma manufacturers and investors scrambling to decipher what and where lies the greatest opportunity for reaping the benefits of biosimilar production.
Biosimilars Growth Areas
There seems to be no shortage of opportunities for pharmaceutical manufacturers to create biosimilar products that treat a wide range of ailments and conditions. Ranging from hormone replacement therapy to immunotherapy, insulin shots, breast cancer and even brain disorders, every biological product approaching LOE has the potential to be a cash-cow opportunity for the quickest and smartest investor.
Additionally, company leadership is bringing a lens to the national and international markets and their corresponding approval processes to deduce where the most financially ripe biosimilar opportunities are. The U.S. imposes lengthy FDA processes for some medications, even though trust in biosimilars is rapidly growing. Meanwhile, the EMEA market has already embraced biosimilars with shorter approval turnarounds and greater prescription rates.
Below, we dig into how pharma C-Suite leadership is designating and pursuing growth areas for biosimilars. By scanning thousands of expert transcripts, earning calls, and various company documents in our extensive content library, we were able to decipher where you can expect to see the most activity in the coming fiscal quarters.
Key Commentary on Biosimilars Growth Areas
Expert Call Transcripts Commentary
“On the market side across Europe, the biosimilars roughly represent 10%, 12% of the total biologics market and it is up from 2% only five years ago, so it’s a pretty nice penetration, and of course, the main growth drivers have been oncology, and immunotherapy. Also, if you look at the therapeutic area coverage, then probably 2/3 of the biologics market value is accessible to biosimilars already and has been accessed. This is perchance that onco and immunotherapies were the first to expire, therefore, 3/4 of the sales are actually happening in those two therapeutic areas. I would imagine that this remains the same in terms of the trend of higher coverage.”
– Former Director of STADA on oncology and immunotherapy being major growth areas for biosimilars Expert Call
“The other thing that Amgen is doing really well is positioning their biosimilar portfolio as being from the manufacturer that basically invented biologics. They know how to manufacture biologics. They have a strong history of quality. They don’t have recalls in their pipeline. They’re positioning it as it’s coming from a manufacturer that you’ve trusted for 25 years. If you’re going to use a biosimilar, why wouldn’t you use one that is from the company that started biologics?”
– Former Novartis Director of Rheumatology Marketing on biological companies taking advantage of biosimilar production and marketing