Payers play a significant role in determining the commercial success of biosimilars—as well as their reference brands—as they decide which products are granted formulary access and preferential reimbursement. Although biosimilars such as Pfizer’s Inflectra and Retacrit are available both in Europe and the United States, the level of their success may vary due to regional differences in the drivers of and barriers to biosimilar uptake. As such, it is necessary for biosimilar developers and manufacturers of branded biologics to understand which factors influence payer decisions regarding biosimilars.

Questions answered:

  • What are payers’ perspectives on the drivers of and barriers to biosimilar uptake?
  • What factors influence which biosimilars are preferred on formularies in the United States?
  • How do payers choose among multiple biosimilars of the same brand in the EU?
  • What strategies do payers use to manage biosimilars?
  • What expectations do payers have for biosimilar discounts?
  • How would the availability of biosimilars influence the pricing of emerging agents?
  • Will payer strategies for biosimilars differ between therapeutic specialties?
  • Has COVID-19 affected the use or coverage of biosimilars?

Key markets covered:

  • France
  • Germany
  • Italy
  • Spain
  • United Kingdom
  • United States

Key companies mentioned:

  • Amgen
  • Boehringer Ingelheim
  • Celltrion
  • Eli Lilly
  • Janssen
  • Johnson & Johnson
  • Merck & Co.
  • Mundipharma
  • Viatris (Mylan)
  • Novartis
  • Pfizer
  • Roche
  • Samsung Bioepis
  • Sandoz
  • Sanofi
  • Teva

Key drugs mentioned:

  • Admelog/Insulin Lispro Sanofi
  • Aranesp
  • Avastin
  • Basaglar/Abasaglar
  • Benepali
  • Binocrit
  • Enbrel
  • Flixabi
  • Herceptin
  • Herzuma
  • Humalog
  • Humira
  • Inflectra
  • Kanjinti
  • Lantus
  • Levemir
  • Mvasi
  • Neulasta
  • Neupogen
  • Nivestim/Nivestym
  • NovoLog/NovoRapid
  • Ogivri
  • Procrit/Epogen
  • Remicade
  • Remsima
  • Rituxan/MabThera
  • Truxima
  • Udenyca
  • Zarzio/Zarxio
  • Ziextenzo
  • Zirabev

Table of contents

  • Biosimilars - Access & Reimbursement - Payer Insights Landscape (US-EU5)
    • A&R Biosimilars U.S. Payer Insights 2021
    • A&R Biosimilars EU5 Payer Insights 2021

Author(s): Hamzah Aideed, M.Sc.; Yashu Malhotra

Hamzah Aideed, M.Sc., is a principal analyst on the Biosimilars team at Clarivate. He conducts primary and secondary market research to provide in-depth analysis and insight into the biopharmaceutical industry. Previously, Mr. Aideed was a senior research executive in consulting at McCann Health, specializing in the design and execution of advanced qualitative and quantitative research methodologies for bespoke ad-hoc consulting projects. He holds an M.Sc. in biotechnology, bioprocessing, and business management from the University of Warwick and a B.Sc. in biological chemistry from Aston University in Birmingham.

Yashu Malhotra, M.Sc., is an associate analyst on the Biosimilars and Oncology teams at Clarivate. Previously, she was a senior analyst in the life sciences at Course5 Intelligence. She also worked in competitive intelligence at WNS Global Services. Ms. Malhotra earned her master’s degree in pharmacy (quality assurance) from India’s Delhi Institute of Pharmaceutical Sciences and Research.