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. 2024 Jan;8(1):115-118.
doi: 10.1007/s41669-023-00447-6. Epub 2023 Nov 3.

Exploring the Influence of Health Insurance Plans on Biosimilar Adoption Rates

Jeremy Costin  1 , Morgane C Mouslim  2 , Mariana P Socal  3 , Antonio Trujillo  1
Affiliations

Exploring the Influence of Health Insurance Plans on Biosimilar Adoption Rates

Jeremy Costin et al. Pharmacoecon Open. 2024 Jan.

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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Conflict of interest statement

The authors declare that there are no conflicts of interest that could bias the outcomes or interpretation of the research findings. All authors involved in this study have no financial, personal, or professional conflicts of interest that could influence the research process or results.

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