Member plans meet with HHS to discuss recommendations
Washington (July 25, 2018) – The Alliance of Community Health Plans (ACHP) calls on the Administration, health plans and professional societies to help foster a robust and competitive biosimilars market. ACHP highlights these innovative therapies as key to lowering drug costs for consumers in its response to the HHS Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs and during a Capitol Hill briefing today.
“Biosimilar medicines hold enormous potential. They can boost access to life-saving drugs for millions of Americans – and by increasing competition, help lower drug prices for consumers,” said ACHP President and CEO Ceci Connolly.
ACHP recommends CMS promote biosimilar medicines by educating physicians about the safety and cost-saving benefits to both patients and the health system. CMS should help ensure appropriate reimbursement policies to incentivize the development and prescribing of biosimilar products. Addressing legal and interchangeability obstacles through regulatory authority is also critical to the development and uptake of biosimilars.
“It’s key that CMS promote these innovative therapies and that starts with educating physicians,” said Connolly. “ACHP member plans are experiencing promising results by encouraging biosimilar adoption. Closely aligned with providers, ACHP plans are uniquely positioned to model biosimilar education for the insurance industry.”
Dean Health Plan of Wisconsin is successfully using biosimilar therapies and estimating hundreds of thousands of dollars in savings. Dean started by identifying a biosimilar version of a biologic specialty drug, launched an effort to transition members to the biosimilar and leveraged their integrated delivery network to spread adoption. Based on a 15 percent overall cost reduction each time the biosimilar is used, there is a potential of $650,000 annual savings with this conversion. Representatives from Dean are in Washington, DC this week to share recommendations with officials at the Department of Health and Human Services.
According to an FDA analysis, Americans could have saved $4.5 billion in 2017 if all of the FDA-approved biosimilars were available to consumers. While biosimilars have the potential to save the health care industry billions of dollars and bring lower-cost options to consumers, barriers to competition have kept many off the market. ACHP applauds the FDA’s recent efforts to boost access and encourage growth of the biosimilars market, including easing the approval and regulatory processes as well as addressing anticompetitive behavior.
ACHP members have a long history of managing drug costs while also ensuring millions of patients have access to innovative therapies. Through close relationships with providers, ACHP plans have been able to educate doctors and patients about the benefits of biosimilars. ACHP and its member plans look forward to working with the Administration to take full advantage of the innovative, lower-cost biosimilars being approved by the FDA.
To access the full text of ACHP’s recommendations, click here.
The Alliance of Community Health Plans (ACHP) is a national leadership organization bringing together innovative health plans and provider groups that are among America’s best at delivering affordable, high-quality coverage and care. ACHP’s member health plans provide coverage and care for more than 21 million Americans across 32 states and the District of Columbia. These organizations focus on improving the health of the communities they serve and are on the leading edge of innovations in affordability and quality of care, including primary care redesign, payment reform, accountable health care delivery and use of information technology. To learn more, go to www.achp.org and follow ACHP on Twitter @_ACHP.