Biosimilar Pricing in The USA

Menachem Bressler, Pharm.D. Candidate 2026

Menachem Bressler, PharmD Candidate of 2026

After nearly three years of litigation, biosimilar versions of Humira have come to market and they can be up to 85% cheaper than the reference product. Yet, very few insurance companies are willing to cover these biosimilars. In fact, the versions that are most commonly covered are the ones that are nearly the same in price as the branded product. This is partially caused by how the pricing of these biosimilars are affecting drug rebates. PBMs usually set rebates to be a percentage of the final drug price. As such, they would be more inclined to cover more expensive products to get a higher rebate. This directly impacts current drug prices since manufactures will price their product similarly to the reference product so that there could be more patients that would be covered and potentially use the product. This results in generic/biosimilar products  being more expensive than they should be. A potential way to address this problem is for manufacturers to make their products interchangeable with the reference product. This could result in more formularies carrying these drugs and more doctors prescribing them. Another option would be to simplify the patent laws so that generic products could enter the market more quickly. This would  result in more competition in the industry, which should lead to cheaper prices. Regardless, the issue of overpriced alternatives remains a multifaceted problem in the US and is an issue that should continue to be discussed.