Biosimilar-first defaults and payment parity in every cancer day unit
Cheaper copies of biological cancer drugs exist but are used far less in some countries than others. Making them the default choice saves billions with no loss of benefit.
NHS England moved most patients to trastuzumab and rituximab biosimilars within a year of launch through commissioning defaults and shared savings; US uptake was slower because reimbursement incentives favoured the originator. The proposal is a bundle of implementation measures for every payer: prescribing systems default to the lowest-cost interchangeable biologic, payment parity so clinics do not lose revenue by switching, pharmacist-led switching protocols with patient information, and public reporting of biosimilar share by centre.
- Prices and value · New cancer drugs routinely cost over $150,000 a year, often for months of benefit. Systems cannot afford them and patients go bankrupt.
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