Exploring the Influence of Health Insurance Plans on Biosimilar Adoption Rates

Jeremy Costin; Morgane C. Mouslim; Mariana P. Socal; Antonio Trujillo

doi:10.1007/s41669-023-00447-6

Exploring the Influence of Health Insurance Plans on Biosimilar Adoption Rates

Jeremy Costin
, Morgane C. Mouslim
, Mariana P. Socal
, Antonio Trujillo

Bloomberg School of Public Health

Research output: Contribution to journal › Article › peer-review

Abstract

Background: We conducted a study to investigate the role of health insurance plans on biosimilar adoption among commercially insured patients in the USA. Flexible and rigid health plans may exhibit differing biosimilar coverage due to variations in cost considerations, formulary design, and provider networks. Objective: To identify the characteristics of switchers and biosimilar initiators for six biologic-biosimilar pairs. Methods: Using claims data from 2015 to 2019, we implement sequential regression models to assess the role of health plans on biosimilars adoption. Findings: We found that low-flexibility plans, such as Health Maintenance Organization (HMOs) and Exclusive Provider Organization (EPOs), are more likely to have patients who are switchers and/or biosimilar initiators. Conclusion: Our findings highlight the importance of health insurance plan design in promoting biosimilar uptake.

Original language	English (US)
Pages (from-to)	115-118
Number of pages	4
Journal	PharmacoEconomics - Open
Volume	8
Issue number	1
DOIs	https://doi.org/10.1007/s41669-023-00447-6
State	Published - Jan 2024

ASJC Scopus subject areas

Pharmacology
Health Policy
Pharmacology (medical)

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Cite this

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abstract = "Background: We conducted a study to investigate the role of health insurance plans on biosimilar adoption among commercially insured patients in the USA. Flexible and rigid health plans may exhibit differing biosimilar coverage due to variations in cost considerations, formulary design, and provider networks. Objective: To identify the characteristics of switchers and biosimilar initiators for six biologic-biosimilar pairs. Methods: Using claims data from 2015 to 2019, we implement sequential regression models to assess the role of health plans on biosimilars adoption. Findings: We found that low-flexibility plans, such as Health Maintenance Organization (HMOs) and Exclusive Provider Organization (EPOs), are more likely to have patients who are switchers and/or biosimilar initiators. Conclusion: Our findings highlight the importance of health insurance plan design in promoting biosimilar uptake.",

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Y1 - 2024/1

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Exploring the Influence of Health Insurance Plans on Biosimilar Adoption Rates

Abstract

ASJC Scopus subject areas

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