The UC Berkeley School of Public Health is pleased to announce that James Robinson, PhD, MPH, professor and chair of the Health Policy and Management Division, has been awarded a two-year, $340,000 grant by the Arnold Ventures Foundation to determine potential cost savings from wider use of biosimilars—therapeutically equivalent but less expensive versions of biologic medical treatments for cancer.
Working with 2017–2022 data from the national BlueCross BlueShield Axis claims warehouse—which includes tens of millions of enrollees and hundreds of millions of claims each year—Robinson will track pricing, consumer cost-sharing, and total spending of cancer biosimilars and biologics and evaluate the potential monetary savings on the part of physicians, patients, and investors.
“Competition finally is coming to the world of expensive cancer therapies, as blockbuster biological drugs lose their patent protection and face cheaper but therapeutically equivalent biosimilars,” said Robinson. “This project will track the adoption of biosimilars and assess the impact of changes in physician payment and consumer insurance coverage on pricing and savings in hospital-based and non-hospital drug infusion clinics.”
Traditionally, prices vary widely between sites of care, depending on the provider’s bargaining power. Insurers are responding to this by adjusting payment methods and changing how consumers share the cost of medication. Reductions in drug prices are important to forestall this tightening of administrative and cost sharing obstacles to patient access.
“Achieving these savings will require changes to insurers’ methods of drug procurement, physicians’ methods of reimbursement, and patients’ insurance benefit designs. This study will contribute to the policy and payer discussions on how to accelerate these changes and achieve the greatest potential benefit from biosimilars in oncology,” said Robinson in his project brief.
“The hope is that savings from biosimilars will free up funds that can be used by health plans to increase patient access to existing drugs and by drug manufacturers to develop the next generation of treatment.”