Exploring the Influence of Health Insurance Plans on Biosimilar Adoption Rates.

IF 2 Q2 ECONOMICS PharmacoEconomics Open Pub Date : 2024-01-01 Epub Date: 2023-11-03 DOI:10.1007/s41669-023-00447-6
Jeremy Costin, Morgane C Mouslim, Mariana P Socal, Antonio Trujillo
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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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探讨健康保险计划对生物类似物采用率的影响。
背景:我们进行了一项研究,以调查健康保险计划在美国商业保险患者采用生物仿制药方面的作用。由于成本考虑、配方设计和提供者网络的差异,灵活和严格的健康计划可能会显示出不同的生物仿制药覆盖范围。目的:鉴定六对生物仿制药的开关和生物仿制药引发剂的特性。方法:使用2015年至2019年的索赔数据,我们实施序列回归模型来评估健康计划对生物仿制药采用的作用。研究结果:我们发现,灵活性低的计划,如健康维护组织(HMO)和独家提供商组织(EPO),更有可能让患者成为转换者和/或生物相似性启动者。结论:我们的研究结果强调了健康保险计划设计在促进生物仿制药吸收方面的重要性。
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来源期刊
CiteScore
3.50
自引率
0.00%
发文量
64
审稿时长
8 weeks
期刊介绍: PharmacoEconomics - Open focuses on applied research on the economic implications and health outcomes associated with drugs, devices and other healthcare interventions. The journal includes, but is not limited to, the following research areas:Economic analysis of healthcare interventionsHealth outcomes researchCost-of-illness studiesQuality-of-life studiesAdditional digital features (including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations) can be published with articles; these are designed to increase the visibility, readership and educational value of the journal’s content. In addition, articles published in PharmacoEconomics -Open may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand important medical advances.All manuscripts are subject to peer review by international experts. Letters to the Editor are welcomed and will be considered for publication.
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