The New Frontier for Improved Access to Medicines

Patient Access & Savings

Biologic medicines, many of which are specialty medicines, are the most rapidly growing segment of brand-name prescription drug costs in the U.S., with more than $100 billion in annual spending. This is creating a disproportionate strain on health spending: while only two percent of America’s patients use biologics, they account for about 40 percent of prescription drug spending in the U.S. As such, the role of biologic drugs in the health care system is expanding. For example, biologic medicines have become the standard of care for many devastating, debilitating and chronic illnesses. While their importance in treating these diseases continues to increase, access to these sometimes lifesaving medicines is denied because health systems simply cannot afford them.

Many stakeholders can benefit from new biosimilars: patients waiting for alternatives to costly biologics; hospitals and care facilities who could reinvest the savings into ongoing in-patient programs, technology, upgraded facilities and additional staff; taxpayers; employers; insurers; state and federal governments; and others who help pay for health care.

For patients, costly biologic medicines are often the only treatments currently available to address many severe diseases. Biologics are used to combat cancer, heart disease, psoriasis, rheumatoid arthritis, asthma, Crohn’s disease, diabetes, multiple sclerosis, and other life-threatening illnesses. For patients, biologic medicines often mean quicker recovery times and fewer additional treatments. Unfortunately, the high price tags keep biologic treatments out of reach for many. In coming years, however, many biologic medicines are expected to reach the end of their patents and exclusivity, which will provide an opportunity for a reduction in health care costs and increasing access of lifesaving medicines to patients in need.

Access to more affordable biosimilar medicines will improve patients’ quality of life and may reduce financial pressures. Increasing access to biosimilars will also help drive down the cost of originator brand biologics, which helps patients and benefits our economy and society.

Competition from biosimilars is important because for many patients, the availability of a high-priced brand biologic for their treatment does not translate into access to these therapies. For example, many rheumatoid arthritis patients in developed countries like Japan, the United States and the E.U. do not have access to these medicines.

Furthermore, in European countries where biosimilars have been introduced, they have increased patient access by as much as 100 percent.10 The greater use of biosimilars can be attributed to their lower cost, as well as revisions to treatment guidelines that reflect improved cost effectiveness.