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Can biosimilars help achieve the goals of US health care reform?

Authors Boccia R, Jacobs I, Popovian R, de Lima Lopes Jr G

Received 28 January 2017

Accepted for publication 22 April 2017

Published 1 June 2017 Volume 2017:9 Pages 197—205

DOI https://doi.org/10.2147/CMAR.S133442

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Akshita Wason

Peer reviewer comments 3

Editor who approved publication: Prof. Dr. Alexandra Fernandes

Ralph Boccia,1 Ira Jacobs,2 Robert Popovian,3 Gilberto de Lima Lopes Jr4

1Center for Cancers and Blood Disorders, Bethesda, MD, 2Global Medical Affairs, Pfizer Inc., New York, NY, 3US Government Relations, Pfizer Inc., Washington, DC, 4Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA


Abstract: The US Patient Protection and Affordable Care Act (ACA) aims to expand health care coverage, contain costs, and improve health care quality. Accessibility and affordability of innovative biopharmaceuticals are important to the success of the ACA. As it is substantially more difficult to manufacture them compared with small-molecule drugs, many of which have generic alternatives, biologics may increase drug costs. However, biologics offer demonstrated improvements in patient care that can reduce expensive interventions, thus lowering net health care costs. Biosimilars, which are highly similar to their reference biologics, cost less than the originators, potentially increasing access through reduced prescription drug costs while providing equivalent therapeutic results. This review evaluates 1) the progress made toward enacting health care reform since the passage of the ACA and 2) the role of biosimilars, including the potential impact of expanded biosimilar use on access, health care costs, patient management, and outcomes. Barriers to biosimilar adoption in the USA are noted, including low awareness and financial disincentives relating to reimbursement. The evaluated evidence suggests that the ACA has partly achieved some of its aims; however, the opportunity remains to transform health care to fully achieve reform. Although the future is uncertain, increased use of biosimilars in the US health care system could help achieve expanded access, control costs, and improve the quality of care.

Keywords: Affordable Care Act, biologics, health policy, patient care, access

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