Estimated reading time: 3 minutes
As specialty drug spending continues to rise, many employers are searching for sustainable ways to manage pharmacy costs without compromising quality of care. One of the most promising solutions emerging today is the use of biosimilars — safe, effective, and more affordable alternatives to expensive biologic drugs.
What Are Biosimilars?
Biosimilars are FDA-approved medications that are highly similar to their brand-name biologic counterparts and have no meaningful differences in safety, purity, or effectiveness. They undergo rigorous testing and clinical review, ensuring that patients can expect the same outcomes they receive from the original biologic therapy.
For example, biosimilars to blockbuster drugs like Humira® and Stelara® are now available in the U.S., creating new opportunities to reduce costs across self-funded health plans.
Why Biosimilars Matter for Employers
Biologic drugs account for nearly half of all prescription drug spending in the United States.1 As more biosimilars enter the market, employers finally have leverage to bring down those costs.
Biosimilars typically launch at up to 50% lower cost than their brand-name biologics, depending on competition and contracting strategies.2 Over time, this competition also pressures brand manufacturers to reduce their own prices — amplifying savings even further. For a self-funded employer, these savings can translate into hundreds of thousands of dollars per year with just a few members transitioning from high-cost biologics to biosimilars.
Marshall+Sterling’s Role in Driving Biosimilar Adoption
Our role extends far beyond negotiating renewals. We act as strategic partners — helping employers implement smarter pharmacy benefit strategies. Here’s how we help clients capture the value of biosimilars:
- Data Analysis: We review pharmacy claims to identify members using high-cost biologics and quantify potential biosimilar savings.
- PBM Evaluation: We assess each pharmacy benefit manager’s formulary to ensure biosimilars are positioned as preferred options.
- Plan Design Guidance: We recommend formulary adjustments, prior authorization updates, or alternative sourcing options that encourage biosimilar use.
- Communication & Support: We provide education for employers and members on biosimilar safety and effectiveness, helping ensure smooth transitions.
- Ongoing Monitoring: We track adoption rates, cost savings, and clinical outcomes — delivering clear reporting on return on investment.
Real-World Biosimilars Impact
The shift is already underway. When Humira® biosimilars launched in 2023, the drug’s sales — which had averaged 8.5% annual growth for five years — fell 23% from 2023 to 2024.3
Stelara®, which reached an estimated $10 billion in sales in 2024, is next in line. With six FDA-approved biosimilars already and more expected, uptake is projected to be faster than Humira – thanks to lessons learned.4
- Discounts range from 5% to over 80% off the brand price
- Industry forecasts suggest a 65% shift to biosimilars by 2027.
Looking Ahead
The biosimilar market is expanding rapidly, with a significant amount of biosimilars expected to enter the market in the next five year. Employers who act early — with informed guidance from their broker — can realize significant pharmacy savings and reinvest those dollars in other strategic initiatives. Biosimilars represent a win-win for employers and members alike: lower costs, equal quality, and greater access to essential therapies. As your trusted benefits partner, Marshall+Sterling is committed to helping you stay ahead of these changes and design a pharmacy strategy that delivers real value for your organization.
Please note: The information above is for general informational purposes only and does not constitute legal advice. For guidance tailored to your plan, contact your Marshall+Sterling Account Manager.
