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Biosimilar Costs Could Exceed Brands In Part D Coverage Gap

 
• By Cathy Kelly

Biosimilars are exempt from the 50% discount manufacturers are required to provide on branded drugs for Medicare Part D beneficiaries in the coverage gap, which may result in a higher cost for the biosimilar relative to its reference drug.

The cost of biosimilars might be greater than their reference brands for Medicare Part D beneficiaries who reach the coverage gap because of a provision in the Affordable Care Act.

The law exempts biosimilars from the 50% discounts manufacturers are required to provide on the negotiated price of branded drugs while beneficiaries are in the Part D coverage gap. As...

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