Blue Shield Of California Push For Cheaper Biosimilars Could Disrupt Market

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Blue Shield California News

Biosimilar,Originator Biologic,Rebates

Joshua Cohen covers healthcare policy, with a special focus on prescription drug pricing and reimbursement. Cohen writes about a wide variety of topics, including weight loss drugs, the Inflation Reduction Act, and even things like health risks related to climate change.

lower-cost Humira-referenced biosimilars have been available to patients. traditional pharmacy benefit managers to offer a Humira -referenced biosimilar named Idacio to patients at the lowest list price currently available, $525. Humira is a self-injectable treatment used for a number of autoimmune disorders.

The $525 list price for Idacio is approximately 25% of what BSC currently pays for Humira after rebates. And the lowest wholesale acquisition cost of one of the Humira-referenced biosimilars that CVS Caremark offers is The novel approach BSC is taking aims to eliminate what it deems to be excessive markups often found in traditional PBM models. Likewise, theTypically, PBMs are the entities in the prescription drug supply chain that negotiate net prices and corresponding rebates with drug makers in exchange for favorable positioning of products on formularies, or lists of therapeutics covered by insurance. This in turn drives market share towards heavily rebated prescription drugs.

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