Why you should care about biosimilars

By Regence
November 17, 2022
Glass vaccine vials

Biosimilars lower costs and expand access

More biosimilars are coming to market, making treatment for complex diseases accessible to more people. Yet the average person may not know about these important treatment options and how they help lower health care costs. Below is an overview.

What is a biologic?

A drug is made by combining chemical ingredients. A biologic is a treatment that is made using a living system like a microorganism or the cells of plants or animals. Biologics are made up of large molecules and are typically injected. You may think of biologics as new, but the technology has been used for more than a century to create vaccines. Insulin is also a form of biologic therapy.

What is a biosimilar?

New biologics are usually given a brand name, such as Humira or Remicade, which is protected by patents for a certain number of years. Once the patent ends, other companies can begin creating biosimilar products that perform the same biological function as the brand name at a much lower price. These are called biosimilars.

Biologics and biosimilars today treat cancer and autoimmune diseases

Biologics and biosimilars work differently than traditional drugs. They are typically used for more targeted therapies in complex diseases. Today, biologics and biosimilars are available to treat rheumatoid arthritis, psoriasis, Crohn’s disease, multiple sclerosis, diabetes, certain cancers, hemophilia and other conditions.

Lower-cost biosimilars expand access to more people

Biologic treatments are expensive, costing between $10,000 and up to $100,000 a year. Biosimilars can cost 15% to 30% less than their reference biologics – still expensive, but less so. As more competition enters the market, it's expected that prices will continue to drop, giving more people access to important therapies to treat disease.

Regence leads industry in biosimilar adoption and cost savings

Regence’s pharmacists continually track new products coming to market and study the research to determine whether they meet the effectiveness and safety standards to be included in our covered drug list. Once adopted, biosimilars generally replace the biologic product on our covered drug list, and we then work closely with our members and their doctors to transition them to the biosimilar. For example, Remicade is a popular biologic that treats conditions such as Crohn’s disease, psoriatic arthritis, rheumatoid arthritis and more.

Regence recently shared how our industry-leading work with biosimilars utilization led to a 95 percent adoption of these lower-cost treatments by health plan members, reducing specialty drug spend by $37 million annually. 

Saving health care costs benefits everyone

A recent American Journal of Managed Care study estimates the savings from biosimilars adoption from 2021 to 2025 to be anywhere between $38.4 billion and $124.5 billion. The higher scenario assumed quicker biosimilar market entry, greater biosimilar adoption, and more aggressive price competition. The cost of health care – doctor’s visits, treatments, drugs – directly affects insurance premiums and out-of-pocket costs. When we can lower costs while maintaining quality of care, everyone benefits.

We’re here to help

Regence members who want to understand what is available through their health plan can sign in to their account on regence.com. You can also live chat or message us after signing in, or call the number on the back of your Regence member ID card.