Interchangeable overhang

CMS's new policy for reimbursement of biosimilars for Medicare Part D drugs won't be a de facto path to interchangeability. But it could make the debate over interchangeability irrelevant because it will allow payers and pharmacy benefit managers to use familiar tools like excluded drugs lists to kick the reference drug off formularies if it means getting a better deal on the biosimilar.

On March 31, CMS issued biosimilar reimbursement coverage memos to plan sponsors outlining its requirements for Medicare parts B and D drugs as well as for state Medicaid agencies. The guidance came three weeks after FDA approved the first biosimilar, Zarxio filgrastim-sndz from the Sandoz unit of Novartis AG...