OBJECTIVES

The Centers for Medicare and Medicaid Services (CMS) publish the average sale prices (ASP) for determining the amount reimbursed by the Medicare Part B program for drugs used in physician offices and other outpatient settings. This study assessed trends in the ASP of therapeutic biologic drugs reimbursed by the Medicare Part B program in the period 1^st quarter 2010- 1^st quarter 2020.

METHODS

Information about the ASP was collected from a database maintained by CMS. Prices were indexed to the first quarter of 2010. Descriptive analysis was conducted for all variables included in the study. T-test was used to assess differences in prices of therapeutic biologics with and without biosimilar competition. Analysis was conducted using IBM SPSS vs.25.

RESULTS

The CMS database contained information for 101 therapeutic biologics reimbursed by the Medicare Program, of which 36 (35.6%) had complete price information and were included in the analysis. Antineoplastic and immunomodulating agents represented 50.0% (n=18) of the biologics included in the analysis. CMS listed ASP prices for three biosimilar products: epoetin alfa (approved by the US FDA in May 2018), filgrastim (March 2015), and infliximab (April 2016). Biologic prices increased an average± standard deviation of 1.9±1.0 times (median=1.7, range=0.9-6.4 times) in the period of analysis. By comparison, the US consumer price index all items increase 1.2 times during the same period. Median indexed prices as of the 1^st quarter of 2020 were significantly lower for biologics with biosimilar competition (110.8 vs. 179.3, p<0001). Biosimilar indexed prices were lower than their respective reference biologics (86.5 vs. 110.8).

CONCLUSIONS

The price of biologics paid by the Medicare Part B increased more than the consumer price index in the period of analysis. Prices of reference biologics with biosimilar competition increased at a lower rate than biologics without biosimilar competition.