Adam Fein says don't give up on biosimilars yet

Reforms are needed but the lower-priced competitors have grabbed significant market share against some reference products
Peter Wehrwein

Peter Bach and his colleague, Mark Trusheim, have provocatively argued that it was time to "throw in the towel" on biosimilars as competitors on price and agents for lowering pharmaceutical spending.

If you want to bring down prices of biologics, regulate them, they say. 

In a worth-your-time blog post this week Adam Fein says Bach and Trusheim are giving up too soon: "This strategy [price regulation] may save some money in the short run, but it risks destroying a market that is finally beginning to fulfill its promise." 

Fein analyzes the biosimilar market by reference products. By his reckoning Zarxio and Granix, biosimilars to Neupogen, are success stories: They had captured two thirds of the market share by mid-2019 and their average sales price is 30%–40% less that Neupogen's. 

It is a different story with Inflectra and Renflexis, biosimilars to Remicade. Fein says they have less than 10% market share as of mid-2019. Why? According to Fein, Johnson & Johnson has offered discounts and rebates to keep sales of Remicade up. Fein cited work by Ronny Gal at Sanford C. Bernstein that shows that 79% of commercial lives are in plans that still give a preference to Remicade. 

Still, Fein takes an optimistic stance on biosimilars while also calling for reforms if biologics are to make serious headway against their reference product. The obstacles he mentions include the  "warped incentives" of buy-and-bill, the 340B program (Fein might be the 340B program's most persistent critic), and rebates.