Jakub P. Hlávka, PhD
Studying the Drivers of Biosimilar Coverage by Commercial Plans and Estimating the Social Welfare Gain from Biosimilar Entry in the United States
Summary
Biosimilars are an equivalent of generic medications for infusion therapies, such as those used in oncology or neurology, and have great potential to lower prices and increase access to otherwise expensive treatments. The first aim of our research is to explore and examine key factors associated with coverage decisions regarding biosimilars that have been approved by the U.S. Food and Drug Administration (FDA) and have become available on the U.S. market, drawing on unique data provided by the Tufts Cost-Effectiveness Analysis Registry and the Specialty Drug Evidence and Coverage Database. Our second aim is to study the social welfare gain from biosimilar entry in the U.S. health care system. By using the SSR Health US Brand Rx Net Pricing data, we will estimate the additional number of patients receiving access to therapy following biosimilar entry, thus enabling us to quantify the extensive margin. We will use data on average net (post-rebate) prices by quarter to calculate the effect of biosimilar entry on the average cost of treatment (intensive margin). Our research will help clarify what drives the prices and utilization of biologics and what determines their coverage by insurance plans in the United States.
Receiving the support from the PhRMA Foundation has allowed me to build a research team consisting of three doctoral researchers and to obtain datasets that we would otherwise not have had access to. The award has accelerated our work on multiple fronts, which we hope will make significant contributions to our understanding of the biosimilar market in the United States.
