October 13, 2021
Media contact: National Consumers League – Carol McKay, firstname.lastname@example.org or (724) 799-5392
Washington, DC—The National Consumers League (NCL) is pleased to support the Star Rating for Biosimilars Act, as introduced by Representatives Paul D. Tonko (D-NY) and Bob Gibbs (R-OH). NCL believes that implementing a rating system for biosimilars would incentivize insurers to provide lower cost drug alternatives and alleviate the financial burdens on patients.
The Centers for Medicare and Medicaid Services (CMS) currently has a star ratings system for insurance plans under Medicare Advantage and Part D. The quality measures capture items such as clinical quality, beneficiary satisfaction, patient outcomes, and regulatory compliance. This rating system helps the CMS evaluate which plans to keep and discontinue. To date, we do not have a comparable rating system where biosimilars are concerned. “Biosimilars are on average 30 percent cheaper than their biologic counterparts, yet many existing barriers in our current healthcare plans prevent patients from accessing these cost-saving medicines,” said NCL Director of Health Policy Jeanette Contreras.
The Star Ratings for Biosimilars Act would require the CMS to put in place a five-star performance rating system for biosimilar products under Medicare Advantage Plans. For each plan, the ratings will be based on quality measures meant to evaluate the level of access that each insurance plan provides to biosimilars, such as whether a biosimilar is on the formulary, and the percentage of enrollees prescribed a biosimilar when its biologic counterpart is available. Aside from Advantage Plans, the bill would also require the CMS to incorporate these measures into a similar rating system for plans under the Medicare Part D prescription drug benefit.
The NCL believes in transparency as a core function of informed decision-making. Knowing whether cost saving biosimilars would be available to enrollees under various Medicare (including the Medicare Advantage plans) and Part D plans would bring in more transparency to help consumers be more informed when selecting a plan. “Allowing consumers to see which plans are offering access to lower cost biosimilars would also incentivize Medicare plans to increase patient access to biosimilars,” said Contreras. We encourage Congress to pass the Star Rating for Biosimilars Act in order to broaden access to and encourage increased provision of cost-saving biosimilars.
About the National Consumers League
The National Consumers League, founded in 1899, is America’s pioneer consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit www.nclnet.org.