{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T02:18:33Z","timestamp":1787883513820,"version":"build-2784847793"},"reference-count":12,"publisher":"American Medical Association (AMA)","issue":"14","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA"],"published-print":{"date-parts":[[2026,4,14]]},"abstract":"\n Importance<\/jats:title>\n Many physician-administered oncology biologics are losing patent protection in the coming years and will face competition from biosimilars. Hospitals and insurers share a mutual interest in developing payment methods that share the potential savings from adopting these less costly agents.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To test whether hospitals paid lower acquisition prices and earned higher markup margins for physician-administered oncology biosimilars; whether insurers reduced the reimbursement prices they paid to hospitals, thereby sharing in the savings from lower manufacturer prices; and whether reductions in acquisition prices and increases in hospital margins were associated with accelerated adoption of biosimilars.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n Observational study using 2020-2024 data for patients covered by Blue Cross Blue Shield health insurance, linked to information on drug acquisition prices paid by hospitals to manufacturers; drug reimbursement prices paid by insurers to hospitals; hospital eligibility for federal 340B price discounts; and other hospital, patient, and market characteristics.<\/jats:p>\n <\/jats:sec>\n \n Exposures<\/jats:title>\n Biologics and biosimilars acquired by hospitals from manufacturers at one price and reimbursed by private insurers at a higher price.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Acquisition prices paid by hospitals to manufacturers, reimbursement prices paid by insurers to hospitals, hospital drug price markup margin, hospital adoption of biosimilars.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Between 2020 and 2024 (66\u202f139 patients who received oncology biologics and biosimilars in 1541 hospitals), acquisition prices paid by hospitals to drug manufacturers declined by 60%, 72%, and 63% for the biosimilars of bevacizumab, trastuzumab, and rituximab, respectively. The reimbursement prices paid by insurers to hospitals declined more slowly, at 32%, 36%, and 34%, allowing an increase in hospital markup margins. In multivariable regression analyses, each additional dollar of acquisition price was associated with $2.72 in higher hospital reimbursement for bevacizumab (95% CI, $0.51-$4.93), $1.82 for trastuzumab (95% CI, $1.27-2.38), and $2.32 for rituximab (95% CI, $1.56-$3.09). Increases in hospital markup margins were associated with increased adoption of biosimilars, rising from a 32%, 37%, and 18% share of bevacizumab, trastuzumab, and rituximab use in 2020 to 93%, 87%, and 84% by 2024.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n Hospital price markup margins from the administration of oncology biosimilars have increased over time and have been accompanied by large increases in the utilization of these therapies.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jama.2026.1777","type":"journal-article","created":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T15:00:33Z","timestamp":1773241233000},"page":"1243","source":"Crossref","is-referenced-by-count":8,"title":["Hospital Adoption and Pricing for Oncology Biosimilars"],"prefix":"10.1001","volume":"335","author":[{"given":"James C.","family":"Robinson","sequence":"first","affiliation":[{"name":"University of California, Berkeley"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ari D.","family":"Kosorukov","sequence":"additional","affiliation":[{"name":"University of California, Berkeley"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher M.","family":"Whaley","sequence":"additional","affiliation":[{"name":"Brown University, Providence, Rhode Island"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"4","key":"joi260006r3","doi-asserted-by":"publisher","first-page":"338","DOI":"10.1056\/NEJMsa2306609","article-title":"Hospital prices for physician-administered drugs for patients with private insurance.","volume":"390","author":"Robinson","year":"2024","journal-title":"N Engl J Med"},{"issue":"7","key":"joi260006r4","doi-asserted-by":"publisher","first-page":"1123","DOI":"10.1377\/hlthaff.2017.1520","article-title":"Hospital-physician consolidation accelerated in the past decade in cardiology, oncology.","volume":"37","author":"Nikpay","year":"2018","journal-title":"Health Aff (Millwood)"},{"issue":"9","key":"joi260006r5","doi-asserted-by":"publisher","first-page":"1395","DOI":"10.1377\/hlthaff.2021.00211","article-title":"Price differences to insurers for infused cancer drugs in hospital outpatient departments and physician offices.","volume":"40","author":"Robinson","year":"2021","journal-title":"Health Aff (Millwood)"},{"issue":"6","key":"joi260006r7","doi-asserted-by":"publisher","first-page":"603","DOI":"10.1001\/jamainternmed.2022.1022","article-title":"Hospital-administered cancer therapy prices for patients with private health insurance.","volume":"182","author":"Xiao","year":"2022","journal-title":"JAMA Intern Med"},{"issue":"7","key":"joi260006r8","doi-asserted-by":"publisher","first-page":"1123","DOI":"10.1377\/hlthaff.2017.1520","article-title":"Hospital-physician consolidation accelerated in the past decade in cardiology, oncology.","volume":"37","author":"Nikpay","year":"2018","journal-title":"Health Aff (Millwood)"},{"issue":"4","key":"joi260006r9","doi-asserted-by":"publisher","first-page":"680","DOI":"10.1377\/hlthaff.2016.0830","article-title":"Evaluating the role of payment policy in driving vertical integration in the oncology market.","volume":"36","author":"Alpert","year":"2017","journal-title":"Health Aff (Millwood)"},{"issue":"156","key":"joi260006r12","first-page":"48772","article-title":"Hospital outpatient prospective payment and ambulatory surgical center payment systems and quality reporting programs.","volume":"85","author":"US Department of Health and Human Services","year":"2020","journal-title":"Fed Regist"},{"key":"joi260006r1","unstructured":"Fact Sheet: bringing lower-cost biosimilar drugs to American patients. US Dept of Health and Human Services. Accessed February 4, 2026. https:\/\/www.hhs.gov\/press-room\/fact-sheet-bringing-lower-cost-biosimilar-drugs-to-american-patients.html"},{"key":"joi260006r2","unstructured":"Driving better healthcare through bigger data. BlueCross BlueShield Association. Accessed December 23, 2021. https:\/\/www.bcbs.com\/about-us\/programs-initiatives"},{"key":"joi260006r6","unstructured":"Fronstin? P, Roebuck? MC, Stuart? BC. Location, location, location: cost differences for oncology medicines based on site of treatment. ERBI Issue Brief. 2020;(498):1-16. Accessed July 15, 2024. https:\/\/www.ebri.org\/docs\/default-source\/ebri-issue-brief\/ebri_ib_498_chemocosts-16jan20.pdf?"},{"key":"joi260006r10","unstructured":"Medicare Part B drug average sales price. Centers for Medicare & Medicaid Services. Accessed December 12, 2025. https:\/\/www.cms.gov\/Medicare\/Medicare-Fee-for-Service-Part-B-Drugs\/McrPartBDrugAvgSalesPrice"},{"key":"joi260006r11","unstructured":"340B Drug pricing program. Health Resources and Services Administration. Accessed May 14, 2023. https:\/\/www.hrsa.gov\/opa"}],"container-title":["JAMA"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jama\/articlepdf\/2846346\/jama_robinson_2026_oi_260006_1782508754.12075.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T15:00:25Z","timestamp":1782745225000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jama\/fullarticle\/2846346"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,14]]},"references-count":12,"journal-issue":{"issue":"14","published-print":{"date-parts":[[2026,4,14]]}},"URL":"https:\/\/doi.org\/10.1001\/jama.2026.1777","relation":{},"ISSN":["0098-7484"],"issn-type":[{"value":"0098-7484","type":"print"}],"subject":[],"published":{"date-parts":[[2026,4,14]]}}}