Milliman predicts that it will be at least 12 years before biosimilars fully penetrate the market in the United States. But the consulting company tells employers that the U.S. market could possibly evolve the same way that it has in Europe, where biosimilars have a healthy presence. Milliman recently updated its 2011 study—“Understanding Biosimilars and Projecting the Cost Savings to Employers(link is external)”—in order to let U.S. businesses know just how biosimilars might impact their health care costs from 2013 to 2019.
The study points out that the Biologics Price Competition and Innovation Act of 2009 (BPCIA) mandates a 12-year exclusivity period for many new biologic drugs. However, since over 70% of the 2013 cost for biologics is for drugs whose 12-year exclusivity has already expired, this should not be a major barrier. Rather, “the approval pathway and return on investment are not necessarily appealing for all biologics or specific drug therapy classes,” the study states…. “As such, biosimilar penetration in the market over the next several years will be small.”
Frank Kopenski, Jr., a principal and consulting actuary at Milliman and the study’s main author, tells Managed Care that “the U.S. trails Europe by about five to six years in the approval process.”
He explains that, “If an employer with 10,000 insured employees and dependents spends on average $51.4 million on health care, the expected cost for biologics is $2.67 million or 5.2% which is the maximum savings potential if biosimilars were available at no cost.”
Kopenski says that, “A 30% discount for biosimilars would represent roughly $800,000 savings or 1.6%. Over time, the introduction of new biologics will work against the percentage savings since newer drugs will have patent protection into the foreseeable future. However, the volume of biosimilars in the market will move toward where Europe is today.”
The hard truth is that telehealth’s future—its size, its contours—will depend a lot on what payers will be willing to pay for. Currently, commercial plans cover only a limited number of services. In addition, research suggests that there may be quality and utilization problems.
Yehuda Handelsman, MD
Evaluating the quality of telemedicine care is about as easy as evaluating the quality of health care, period, and researchers are still ironing out the methodological kinks. That may be one reason research results are all over the place. This article involved reviewing nine such studies, and the findings are a mixed bag.
RWE is a relatively new kid on the block. How exactly it will fit into the complicated world of cancer drug testing, approval, regulation, and marketing is uncertain. The randomized clinical trial has been the gold standard in oncology research for decades and will remain so for the foreseeable future.
American Telemedicine Association
If millions of Americans lose Medicaid or private health insurance coverage because of the unACAing of American health care, telehealth may seem like a gimmicky sideshow rather than a good-faith effort to bring health care into the digital century.
The FDA has given the green light to abaloparatide subcutaneous injection (Tymlos, Radius Health) for the treatment of postmenopausal women with osteoporosis at high risk for fracture, defined as a history of osteoporotic fracture, multiple risk factors for fracture, or patients who have failed on or are intolerant of other available osteoporosis therapy.
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Paul Lendner ist ein praktizierender Experte im Bereich Gesundheit, Medizin und Fitness. Er schreibt bereits seit über 5 Jahren für das Managed Care Mag. Mit seinen Artikeln, die einen einzigartigen Expertenstatus nachweisen, liefert er unseren Lesern nicht nur Mehrwert, sondern auch Hilfestellung bei ihren Problemen.