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Interchangeable Biosimilars May Qualify For ‘Immediate Substitution’ In Medicare Part D

21 Dec 2022

Proposed policy could help promote uptake of interchangeable biosimilars to AbbVie’s blockbuster Humira. However, some PBMs and insurers are not persuaded that interchangeability is a useful distinction so may not rush to take advantage of the new flexibility.

Part D interchangeable — Immediate Substitution Not Allowed For Non-Interchangeable Biosimilars • Source: Nielsen Hobbs; the Pink Sheet | Shutterstock images

Beginning in 2024, Medicare Part D plans would be permitted to substitute interchangeable biosimilars as soon as they are available, without waiting for the beginning of the next benefit year, under a proposed rule released by the Centers for Medicare and Medicaid Services on 14 December.

The policy is included in the Contract Year 2024 Policy and Technical Changes to the Medicare Advantage Program and Medicare...