Biosimilars Could Give Brands the Boot Mid-Year Under Amendment Added to Senate PBM Reform Bill

However, the low CBO score attached to the measure may suggest PBMs might not be incentivized to follow through on the congressional permission.

legs up in air with colorful cowboy coots in kicking motion
A measure to facilitate faster biosimilar coverage was added to the Senate Finance Committee PBM package • Source: Shutterstock

Medicare Part D plans could switch the coverage status of a reference biologic midyear if the plan adds a biosimilar for that product to the formulary, under an amendment added to the Senate Finance Committee’s pharmacy benefit manager reform package, which cleared the committee on a 26-1 vote 26 July.

The amendment from Sens. Debbie Stabenow, D-MI, and James Lankford, R-OK, was added to the chairman’s mark of the Modernizing and Ensuring PBM Accountability (MEPA) Act ahead of the markup.

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