Bill Overview
Title: Lowering Costs by Improving Biosimilar Uptake Act
Description: This bill allows for the omission of certain information relating to the strength of a product in a biosimilar application, as determined by the Food and Drug Administration.
Sponsors: Rep. Schrader, Kurt [D-OR-5]
Target Audience
Population: Patients in need of biologics that have biosimilar alternatives
Estimated Size: 30000000
- Biosimilars are typically used in the treatment of chronic diseases such as cancer, diabetes, and autoimmune disorders.
- Reductions in the cost of biosimilars can make these treatments more accessible to patients who would otherwise be unable to afford them.
- The legislation will primarily affect healthcare providers and patients who require medications that have biosimilar options.
- Patients who are currently using originator biologics may switch to biosimilars if the cost is more competitive.
- As biosimilars cover a wide range of diseases treated globally, the population possibly affected is extensive.
Reasoning
- The policy budget is limited, so although the target population is large, not everyone will experience significant immediate impact. Many will not be directly affected within the early years due to budget constraints.
- A spectrum of perspectives is needed, as only those currently using or in need of biologics with biosimilar options will feel a direct impact from the policy.
- Consider patients with different chronic diseases to cover a range of impacts, such as those with access issues or those already receiving treatment.
- Healthcare providers are also included, as they will be instrumental in implementing the uptake of biosimilars.
- Those who may not be affected directly in terms of health will likely express opinions about the healthcare system and its efficiency.
Simulated Interviews
Retired Teacher (Houston, Texas)
Age: 58 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 3.0 years
Commonness: 10/20
Statement of Opinion:
- I've struggled to afford my diabetes medication. If biosimilars become cheaper and are covered by my insurance, it could relieve a lot of financial stress.
- Switching to a biosimilar sounds promising, as long as it's safe and effective.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 5 |
| Year 5 | 6 | 5 |
| Year 10 | 6 | 5 |
| Year 20 | 5 | 4 |
IT Specialist (Los Angeles, California)
Age: 35 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 10.0 years
Commonness: 8/20
Statement of Opinion:
- My biologic medication is expensive, even with insurance. Biosimilars could save me money, especially if they work just as well.
- The policy might make it easier for people like me to manage a chronic condition without going into debt.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 7 |
| Year 2 | 8 | 7 |
| Year 3 | 8 | 6 |
| Year 5 | 8 | 6 |
| Year 10 | 8 | 5 |
| Year 20 | 7 | 4 |
Nurse Practitioner (Boston, Massachusetts)
Age: 43 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 5.0 years
Commonness: 6/20
Statement of Opinion:
- Increased use of biosimilars could help our clinic provide better care without stretching budgets.
- Patients often skip doses due to costs, so affordability is key to better outcomes.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 7 |
| Year 2 | 8 | 7 |
| Year 3 | 8 | 7 |
| Year 5 | 7 | 7 |
| Year 10 | 7 | 6 |
| Year 20 | 6 | 5 |
Graduate Student (Seattle, Washington)
Age: 29 | Gender: other
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 5/20
Statement of Opinion:
- The high cost of my medication often affects my study plans, as I need to work more to support myself.
- If the biosimilar option is affordable and effective, it could change my life.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 8 | 4 |
| Year 10 | 8 | 4 |
| Year 20 | 7 | 3 |
Retired (Phoenix, Arizona)
Age: 62 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 0.0 years
Commonness: 12/20
Statement of Opinion:
- While I'm not directly affected by this policy right now, I support anything that can help people get the medication they need.
- Hopefully, in the future, there might be biosimilars for my condition too.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 5 |
| Year 2 | 5 | 5 |
| Year 3 | 5 | 5 |
| Year 5 | 5 | 5 |
| Year 10 | 5 | 5 |
| Year 20 | 5 | 5 |
Insurance Agent (Chicago, Illinois)
Age: 50 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 3.0 years
Commonness: 14/20
Statement of Opinion:
- The introduction of more affordable biosimilars could help us offer better plans without increasing premiums.
- This policy encourages competition, which is beneficial for everyone.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 8 | 7 |
| Year 3 | 8 | 7 |
| Year 5 | 7 | 7 |
| Year 10 | 7 | 6 |
| Year 20 | 6 | 6 |
Retired Healthcare Administrator (Miami, Florida)
Age: 70 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 2.0 years
Commonness: 15/20
Statement of Opinion:
- Healthcare costs are a burden on seniors. If biosimilars lower drug costs, it’s a welcome change.
- The policy has the potential to ease financial pressures on Medicare too.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 6 | 6 |
| Year 3 | 6 | 6 |
| Year 5 | 6 | 6 |
| Year 10 | 6 | 6 |
| Year 20 | 5 | 5 |
Marketing Specialist (New York, New York)
Age: 25 | Gender: female
Wellbeing Before Policy: 8
Duration of Impact: 0.0 years
Commonness: 18/20
Statement of Opinion:
- I see this policy as a positive move towards making medications more affordable and accessible.
- Healthy people might not feel the impact directly, but cheaper drugs mean a healthier society overall.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 8 |
| Year 2 | 8 | 8 |
| Year 3 | 8 | 8 |
| Year 5 | 8 | 8 |
| Year 10 | 8 | 8 |
| Year 20 | 8 | 8 |
Pharmaceutical Sales Rep (Denver, Colorado)
Age: 39 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 7/20
Statement of Opinion:
- While the policy may be great for patients, it could impact my job negative as biosimilars could cut into our sales.
- I might have to adapt to new market demands and possibly find opportunities in biosimilar markets instead.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 6 |
| Year 2 | 6 | 6 |
| Year 3 | 6 | 7 |
| Year 5 | 6 | 7 |
| Year 10 | 6 | 7 |
| Year 20 | 5 | 6 |
Primary Care Doctor (Rochester, New York)
Age: 46 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 6.0 years
Commonness: 11/20
Statement of Opinion:
- I'm hopeful that this policy will allow more of my patients access to the medications they need without financial strain.
- It also presents an opportunity to push for more policies focusing on affordability and access to healthcare.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 8 | 7 |
| Year 3 | 8 | 7 |
| Year 5 | 7 | 6 |
| Year 10 | 7 | 6 |
| Year 20 | 6 | 6 |
Cost Estimates
Year 1: $20000000 (Low: $15000000, High: $30000000)
Year 2: $15000000 (Low: $10000000, High: $25000000)
Year 3: $10000000 (Low: $5000000, High: $20000000)
Year 5: $5000000 (Low: $2500000, High: $15000000)
Year 10: $0 (Low: $0, High: $0)
Year 100: $0 (Low: $0, High: $0)
Key Considerations
- Accelerating the uptake of biosimilars can significantly drive down drug costs and improve access to essential medications for chronic conditions.
- The policy's success depends on stakeholder engagement, including healthcare providers, payers, and consumers.
- Adoption rates of biosimilars can vary due to existing market dynamics and patent litigation outcomes.