Today, a group of organizations representing patients, employers, taxpayers, providers, communities of color and consumer groups sent a letter thanking Representatives Kurt Schrader (D-OR) and Adam Kinzinger (R-IL) for introducing the BIOSIM Act (H.R. 2815). This legislation is critical to reducing costs and improving patient access to biosimilars in the U.S. by providing a temporary increase to physician reimbursement. Under Medicare Part B, biosimilars are currently reimbursed at the average sales price (ASP) + 6%. The BIOSIM Act would increase biosimilar reimbursement by two percent to ASP+8%. Importantly, this incentive payment would apply only when a biosimilar’s price is lower than the price of the brand-name biologic.
We greatly appreciate the work Representatives Schrader and Kinzinger are doing to advance biosimilars and look forward to working with them to have their bipartisan legislation signed into law.
Below is a list of organizations who joined us in endorsing the BIOSIM Act :
- 60 Plus Association
- Advocacy & Awareness for Immune Disorders Association
- Allergy & Asthma Network
- Alliance for Aging Research
- Alliance for Retired Americans
- Alliance to Solve PANS & Immune-Related Encephalopathies (ASPIRE) American Consumer Institute
- Black Women’s Health Imperative
- Center for Freedom and Prosperity
- Consumer Action
- Dallas-Fort Worth Business Group on Health Endocrine Society
- Hypertrophic Cardiomyopathy Association International Pemphigus and Pemphigoid
- Foundation Lupus Foundation of America
- Men’s Health Network
- National Center & Caucus on Black Aging
- National Consumers League
- Patients Rising Now
- R Street Institute
- Rheumatology Nurses Society
- Scleroderma Foundation
- Sister’s Network, Inc.
- Sjögren’s Foundation
- Texas Business Group on Health
- The Mended Hearts, Inc.
The full letter can be found here:
Dear Congressman Schrader and Congressman Kinzinger:
On behalf of the millions of patients, consumers, providers, communities of color and taxpayers our organizations represent, we write to thank you for your leadership in introducing the BIOSIM Act (H.R. 2815). Biosimilar medicines hold enormous potential to lower the cost of prescription drugs but face significant barriers to adoption. Congressional action on innovative solutions, like the BIOSIM Act, is critical to reducing costs and improving patient access to biosimilars in the U.S.
The Food and Drug Administration (FDA) has approved 29 biosimilar medicines since 2015. Patients with cancer, chronic kidney disease, rheumatoid arthritis and other conditions are benefitting from access to biosimilars. According to a recent analysis, women, seniors, and low-income individuals are expected to benefit most from increased access to biosimilars as they are predominantly impacted by the conditions currently treated by higher cost biologics for which biosimilar competition can reduce costs. However, despite average cost savings of 30 percent, biosimilar adoption continues to trail expectations.
Efforts to increase awareness and educate patients and providers about the availability and benefits of biosimilar medicines are important. But misaligned financial incentives within the Medicare program continue to encourage the use of high-cost brand biologics even when a lower-cost biosimilar medicine is available. Recent analysis shows how Medicare reimbursement can influence biosimilar adoption and suggests how payment proposals could be modified to create incentives to spur adoption.
We are deeply appreciative of your thoughtful approach to generating targeted savings for Medicare and reducing out-of-pocket costs for seniors. The BIOSIM Act would accelerate patient access to new biosimilar treatments by providing a temporary increase to physician reimbursement. Under Medicare Part B, biosimilars are currently reimbursed at the average sales price (ASP) + 6%. The BIOSIM Act would increase biosimilar reimbursement by two percent to ASP+8%. Importantly, the policy only applies when a biosimilar’s price is lower than the price of the brand-name reference biologic. This guarantees savings to Medicare and reduces out-of-pocket costs for seniors. For these reasons, we, the undersigned organizations, are pleased to endorse the BIOSIM Act. We look forward to working with you to advance your bipartisan legislation into law.