Amelia M. Bond (
Emma B. Dean, University of Miami, Miami, Florida.
Health Aff (Millwood). 2023 May;42(5):632-641. doi: 10.1377/hlthaff.2022.00812.
Biosimilar drugs-lower-cost alternatives to expensive biologic drugs-have the potential to slow the growth of US drug spending. However, rates of biosimilar uptake have varied across hospital outpatient providers. We investigated whether the 340B Drug Pricing Program, which offers eligible hospitals substantial discounts on drug purchases, inhibits biosimilar uptake. Almost one-third of US hospitals participate in the 340B program. Using a regression discontinuity design and two high-volume biologics with biosimilar competitors, filgrastim and infliximab, we estimated that 340B program eligibility was associated with a 22.9-percentage-point reduction in biosimilar adoption. In addition, 340B program eligibility was associated with 13.3 more biologic administrations annually per hospital and $17,919 more biologic revenue per hospital. Our findings suggest that the program inhibited biosimilar uptake, possibly as a result of financial incentives making reference drugs more profitable than biosimilar medications.
生物类似药——昂贵的生物制药的低成本替代品——有可能减缓美国药品支出的增长。然而，医院门诊供应商之间的生物类似药采用率存在差异。我们调查了 340B 药品定价计划是否会抑制生物类似药的采用，该计划为符合条件的医院提供药品采购的大幅折扣。近三分之一的美国医院参与了 340B 计划。我们使用回归不连续设计和两种具有生物类似物竞争的高销量生物制剂，粒细胞集落刺激因子和英夫利昔单抗，估计 340B 计划的资格与生物类似药采用率降低 22.9 个百分点有关。此外，每所医院每年因 340B 计划资格而增加 13.3 次生物制剂管理，每所医院增加 17919 美元的生物制剂收入。我们的研究结果表明，该计划抑制了生物类似药的采用，这可能是因为财务激励措施使参考药物比生物类似药物更有利可图。
