Site-Neutral Payment And Biosimilars Competition Are Complementary Purchaser Strategies For Cancer Biologics.

Area of Science:

• Health Economics
• Oncology
• Health Policy

Background:

• Rising costs of infused cancer biologics necessitate policy interventions.
• Two primary strategies, biosimilar competition and site-neutral payment, aim to reduce spending.
• Understanding the comparative effectiveness of these policies is crucial for cost containment.

Purpose of the Study:

• To compare the potential cost savings of implementing biosimilar competition versus site-neutral payment strategies for cancer biologics.
• To quantify the financial impact of each policy on healthcare spending.

Main Methods:

• Analysis of deidentified claims data from national Blue Cross Blue Shield plans (2020-2022).
• Inclusion of 43,643 patients with 429,517 infusion visits for cancer biologics and biosimilars.
• Comparison of potential savings under full implementation of each policy strategy.

Main Results:

• Potential savings from site-neutral payment reached $1.004 billion over three years.
• Potential savings from biosimilar competition were $0.465 billion over the same period.
• Site-neutral payment demonstrated double the savings potential compared to biosimilar competition.

Conclusions:

• Site-neutral payment policy is a more effective strategy for reducing spending on infused cancer biologics than biosimilar competition.
• Policy implications favor site-neutral payment for significant cost moderation in cancer care.
• Further research may explore optimal implementation of site-neutral payment policies.