(26) The economic benefit of biosimilars in North America: a targeted literature review

Background: : Biosimilars are biological medicines that provide similar efficacy and safety to their reference products at a more affordable price. The first biosimilar approved in the United States, Canada, and Mexico was in 2015, 2009, and 2010, respectively. Since then, several biosimilars have been approved and launched in each market. A key benefit of biosimilars is the potential for considerable economic savings, depending on utilization rates.

Objective: : The objective of this study was to assess the current and expected savings from biosimilar use in North America.

Methods: : A literature search was conducted using MEDLINE and grey literature from January 2020 to January 2025. Keywords included “projection*”, “economic”, “ex ante analysis”, “budget impact model”, and “biosimilar*”. Peer-reviewed publications and economic reports from industry, accredited associations, and relevant government agencies were included.

Results: : Twenty-seven peer-reviewed publications and four reports were deemed relevant to the search question. Analyses were conducted for the US (n=20) and Canada (n=11). An economic benefit was reported or forecasted by 93% (n=29) of studies, all of which reported substantial savings for both Canadian and US payers. Across Medicare and commercial plans in the US, biosimilar use was estimated to provide a savings of $12.4 billion in 2023 alone. The report also found that biosimilar competition created 495 million incremental days of patient therapy. Moreover, a projection report estimated that the use of biosimilars between 2022 to 2027 could yield $125 to $237 billion in savings for the US healthcare system. A more focused analysis on six biosimilars for the treatment of psoriasis reported $63 million in cost avoidance for the national Veteran Health Administration. In Canada, non-medical switching policies have been implemented to drive biosimilar uptake. The pilot adopter province (British Columbia) realized $731 million in savings between 2019-2024 from nine biosimilars. Analyses indicate even one biosimilar can result in meaningful savings, as pro-active switch policies applied to a ranibizumab biosimilar could provide an estimated $140 million in savings nationally.

Conclusions: : A sizeable and growing body of literature validates the substantial economic benefits that could be realized with the introduction or increased uptake of biosimilars for the US and Canada. Health economic decision makers should consider policies that favor biosimilar use as a tool to help control costs.

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