Radar on Drug Benefits

Commercial Insurance Restrictions Complicate Biosimilar Adoption

  • May 25
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    May 25, 2023

    Since the FDA’s approval of the first biosimilar in 2015, the agency has approved almost 40 more agents. However, their adoption in the U.S. market has been slow. A recent study, published in the journal BioDrugs, found that biosimilars were covered more restrictively than their reference biologics in 19.4% of coverage decisions made by select commercial health plans.

    The study examined 1,181 coverage decisions made by 17 commercial health plans as of August 2021 from the Tufts Medical Center Specialty Drug Evidence and Coverage database, which included 19 commercially available biosimilars for seven biologic reference products used in treating 28 conditions.

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    • Jinghong Chen

    Jinghong has been producing infographics and data stories on employer-sponsored insurance, public health insurance programs and prescription drug coverage for AIS Health’s Health Plan Weekly and Radar on Drug Benefits since 2018. She also manages AIS Health’s annual executive compensation database for top insurers and Blue Cross and Blue Shield affiliates. Before joining AIS Health, she interned at WBEZ, Al Jazeera English and The New York Times Chinese. She graduated from Missouri School of Journalism with a focus on data journalism and international reporting.

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Lauren Flynn Kelly

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Managing Editor, Health Plan Weekly and Radar on Drug Benefits

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Reporter, Health Plan Weekly and Radar on Drug Benefits

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Carina Belles

Reporter, Radar on Medicare Advantage and Spotlight on Market Access

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Jinghong Chen

Reporter, Health Plan Weekly and Radar on Drug Benefits

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Jill Drachenberg

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