Out-Of-Pocket Spending for Biologic Drugs After Biosimilar Competition for Medicare Patients

Among nearly 275,000 Medicare Advantage patients who used one of seven clinician‑administered biologics, average annual out-of-pocket spending fell by about $94 within four years of biosimilar competition, with savings concentrated among patients with coinsurance or deductibles. These findings contrast reports of inconsistent out-of-pocket savings for patients with private insurance, suggesting that Medicare’s reimbursement for biologics based on average sales prices allows biosimilar competition to translate more directly into patient savings.