Ascension called on U.S. House of Representatives lawmakers Thursday to encourage more biosimilar use, claiming it could lower staggering drug costs that are hampering care.
Although Ascension is the biggest not-for-profit hospital chain, it claims it has trouble obtaining volume-based discounts for drugs and only 18.6% of its drug spending involves products that have steady prices for an entire year.
"Contrary to popular belief, very few manufacturers are willing to enter into a contract for their product or offer volume-related discounts or accommodations for even the largest of health systems, like ours," Chief Pharmacy Officer Lynn Eschenbacher said in the House Energy & Commerce's health subcommittee hearing.
Every week, Ascension sees up to 40 drug price increases, she said. But biosimilars could help assuage some of the sticker shock.
More than 15 biosimilars have been approved in the U.S., but the market for biosimilars has been tepid thanks to litigation and slow adoption by physicians. Insurers and pharmacy benefit managers may not add biosimilars to their formularies or deny claims for the cheaper drugs, forcing Ascension or other providers to stop using them.
"To spur competition, Congress should support faster approval and marketing of generics and biosimilars," Eschenbacher said. "Congress also needs to address the fragmentation and artificial barriers that exist in the pharmacy marketplace."
Drug companies also blasted pharmacies and PBMs for blocking biosimilars.
"Because of rebate strategies it makes it difficult for us to get on formularies," said Justin McCarthy, senior vice president of Pfizer's patient & impact group.
However, PBM giant Express Scripts said biosimilars cost too much as generic drugs.
"It is the net cost," said Amy Bricker, Express Scripts' vice president of supply chain. "When biosimilars come to market they have to bring value. We expect a generic product to be less expensive than the innovator."
Bricker also bashed a HHS' proposed rule to eliminate the Medicare Part D's safe harbor for rebates and replace it with a safe harbor for discounts delivered at the point-of-sale, alleging the change would take away a major lever that insurers and PBMs use to get drug companies to lower prices.