Will the emerging private-label market access channel help or hinder biosimilar market access?
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View abstract on PubMed
Summary
This summary is machine-generated.Pharmacy benefit managers (PBMs) shifted adalimumab biosimilar coverage to private-label products in April 2024. This change may boost biosimilar uptake but raises concerns about transparency and competition.
Area Of Science
- Health Economics
- Pharmaceutical Policy
- Drug Development
Background
- Adalimumab biosimilar uptake was low (2-3%) until April 2024.
- Major pharmacy benefit managers (PBMs) controlled 80% of US prescriptions.
- PBMs previously kept the reference product on formulary, limiting biosimilar access.
Purpose Of The Study
- To analyze the impact of a major PBM's policy change on adalimumab biosimilar uptake.
- To examine the implications of private-label biosimilar arrangements on competition and transparency.
- To assess the broader effects on biosimilar markets beyond adalimumab.
Main Methods
- Analysis of PBM formulary coverage policies.
- Monitoring of biosimilar uptake trends.
- Review of private-label biosimilar arrangements and their market impact.
Main Results
- A major PBM shifted formulary preference to private-label and branded biosimilars, excluding the reference product.
- Other large PBMs adopted similar private-label strategies, potentially increasing biosimilar uptake.
- These arrangements may introduce transparency issues and hinder broader biosimilar competition.
Conclusions
- The private-label channel shows promise for increasing biosimilar uptake but may create new market challenges.
- Concerns regarding transparency, conflicts of interest, and competition extend to other biosimilars like ustekinumab.
- Stakeholders must monitor these developments for the sustainability of the biosimilar market.
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