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Biosimilar Trends in Medicare Part B

Biologic drugs-large, complex molecules produced in a living system-are among the most expensive drugs on the U.S. market. Biosimilar drugs are highly similar and have no clinically meaningful difference from their reference biologics and also tend to be less expensive. Medicare Part B and beneficiaries have the potential to spend less on prescription drugs with the increased use of biosimilars rather than their reference biologics, but their use remains low. Limited biosimilar use in Part B may be related to how providers are reimbursed for these drugs-currently, providers do not have strong financial incentives to use less expensive biosimilars. This study will describe use and cost trends of biosimilars and reference biologics covered by Part B over time. It also will determine how much Medicare and beneficiaries paid for biosimilars and reference biologics covered by Part B in 2021, and then compare those costs to determine how much Part B and beneficiaries could have spent with increased use of biosimilars or with different reimbursement policies.

Announced or Revised Agency Title Component Report Number(s) Expected Issue Date (FY)
February 2022 Centers for Medicare and Medicaid Services Biosimilar Trends in Medicare Part B Office of Evaluation and Inspections OEI-05-22-00140 2023