Bending the Reference Biologic Price Curve

One of the most obvious components of savings associated with biosimilars is their effect on competition, driving prices down. One of the more overlooked components of biosimilar savings is another characteristic of competition: Once launched, the cost of reference products stop rising.

That seems intuitive, but the extent of list price increases for reference biologics not facing biosimilar competition underscores the point. A post co-written by Xcenda and the Biosimilars Forum quantified this effect for a number of biologics already affected by biosimilar launches. They examined a 6-year window ending in 2021 and estimated the average sales price (which considers discounts and rebates) of each reference agent had biosimilar competition not occurred. For example, they forecast that the ASP price of Remicade® would be 150% greater than it is today. Neulasta® would be selling for 96% more than we are actually paying today. The reference epoetin alpha agents would be 61% more.

Drug rebates

In general, the older the biosimilar launch, the greater the difference between the actual ASP and what it would have been without competition. That makes sense. Also, the newer biosimilars (e.g., trastuzumab, bevacizumab, and rituximab) have a smaller spread, partly because they would not have been subject to several additional years of price increases.

On the other hand, the prices of etanercept and adalimumab have continued to climb. Although not reflecting the ASPs of these reference agents, we estimated cumulative price increases (based on WAC) of more than 50% through 2023 for adalimumab. This should come to an abrupt halt with the introduction of the first biosimilar in 2023 for adalimumab, but not for etanercept, which may not face direct competition until the end of the decade because of a flawed patent system.

In other biosimilar news… AbbVie keeps playing the patent game in its battle to keep upstart Alvotech from launching its biosimilar version of Humira® before 2023. Big Molecule Watch reported that Humira’s manufacturer launched another patent suit against Alvotech. Apparently, when Alvotech provided its notice of commercial marketing in May as part of ongoing legal proceedings, AbbVie believes that the manufacturer demonstrated its intent to launch its biosimilar at risk. AbbVie wants to enforce 58 patents that it originally declined to litigate against Alvotech. The IP games continue…

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