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Big Molecule Watch
October 24, 2019

Legislation Focused on Market Access to Biosimilars

This month, the Star Ratings for Biosimilars Act was introduced in the House. H.R. 4629 is a bipartisan bill that requires the U.S. Department of Health and Human Services (HHS) to evaluate Medicare Advantage (MA) plans based on whether biosimilars are available to enrollees, and adds “a new set of measures to the 5-star rating system under the Medicare Advantage program in order to encourage increased access to biosimilar biological products.” Parallel provisions have been put forth in the Senate under the Prescription Drug Pricing Reduction Act of 2019 (S.2543).

Also this month, an additional bill passed two committees in the House of Representatives. The Lower Drug Costs Now Act, H.R. 3, included an amendment to increase reimbursement for biosimilar drugs in Medicare Part B to the average sales price (ASP) plus 8%, up from the current 6% plus ASP, for 5 years. This idea was introduced last month as a separate bill, called the BIOSIM Act (H.R. 4455).

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