{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T15:45:25Z","timestamp":1792079125704,"version":"4.4.0"},"reference-count":31,"publisher":"American Medical Association (AMA)","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Oncol"],"published-print":{"date-parts":[[2026,10,1]]},"abstract":"\n Importance<\/jats:title>\n Biosimilars are highly similar to originator biologics and were introduced to increase market competition, lower the price of biologics, and expand patient access by improving affordability. By the end of 2024, three anticancer biologics have experienced biosimilar entry in the US (bevacizumab, rituximab, and trastuzumab), underscoring the need to evaluate their financial implications for payers and patients.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To assess market dynamics and examine financial implications associated with biosimilar use patterns among patients who received bevacizumab, rituximab, or trastuzumab.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This retrospective cohort examined price and market share trends and payer and patient costs after biosimilar entry. It used data from the Merative MarketScan commercial database and Medicare database from July 2019 to December 2024. Based on use patterns within 12 months of treatment initiation, patients were categorized into 4 groups: those who exclusively used biosimilars, exclusively used the reference product (ie, originator biologics), switched from the reference product to biosimilars, and switched from biosimilars to the reference product. Data were analyzed between September 2025 and March 2026.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The primary study outcomes were average sales price (ASP), market share of reference products, and mean monthly payer and out-of-pocket costs within the study period.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Among 14\u202f655 patients in this study, the mean (SD) age was 57 (13) years, 9985 (68.1%) were female, and the most common cancers were breast cancer (5182 [35.4%]), lymphoma (4320 [29.5%]), and colorectal cancer (1998 [13.6%]). A total of 8710 patients (59.4%) exclusively used biosimilars, 4760 (32.5%) exclusively used the reference product, 1015 (6.9%) switched from the reference product to biosimilars, and 170 (1.2%) switched from biosimilars to the reference product. After biosimilar entry, the ASP of the 3 reference products declined by an average of 3.8% annually. Their market share decreased 30% annually in commercial insurance and 31.5% in the Medicare Part B market. Compared with patients who only used the reference product, those who only used biosimilars rendered a $3820 lower mean monthly payer cost and $39.50 lower mean monthly out-of-pocket cost.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n The results of this cohort study suggest that biosimilar entry was associated with lower ASP and reduced market share for reference biologics in oncology. Market competition introduced by biosimilars was also associated with lowered payer costs and reduced patient financial burden.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamaoncol.2026.3128","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T15:30:33Z","timestamp":1787844633000},"page":"1126","source":"Crossref","is-referenced-by-count":0,"title":["Cancer Biologics Utilization After Biosimilar Entry and Financial Implications For Payers and Patients"],"prefix":"10.1001","volume":"12","author":[{"given":"Xiaoyu","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyi","family":"Xu","sequence":"additional","affiliation":[{"name":"Jonsson Comprehensive Cancer Center, Program in Cancer Health Economics Research, University of California, Los Angeles"},{"name":"Department of Radiation Oncology, David Geffen School of Medicine, University of California, Los Angeles"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Z John","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ya-Chen Tina","family":"Shih","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles"},{"name":"Jonsson Comprehensive Cancer Center, Program in Cancer Health Economics Research, University of California, Los Angeles"},{"name":"Department of Radiation Oncology, David Geffen School of Medicine, University of California, Los Angeles"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"10","key":"coi260047r1","doi-asserted-by":"publisher","first-page":"1184","DOI":"10.6004\/jnccn.2019.7305","article-title":"Financial burdens of cancer treatment: a systematic review of risk factors and outcomes.","volume":"17","author":"Smith","year":"2019","journal-title":"J Natl Compr Canc Netw"},{"issue":"9","key":"coi260047r2","doi-asserted-by":"publisher","first-page":"166","DOI":"10.21037\/atm.2018.03.28","article-title":"Financial toxicity and implications for cancer care in the era of molecular and immune therapies.","volume":"6","author":"Tran","year":"2018","journal-title":"Ann Transl Med"},{"issue":"3","key":"coi260047r3","doi-asserted-by":"publisher","first-page":"e299","DOI":"10.1200\/JOP.2015.006700","article-title":"Cost differential of chemotherapy for solid tumors.","volume":"12","author":"Nadeem","year":"2016","journal-title":"J Oncol Pract"},{"issue":"17","key":"coi260047r5","doi-asserted-by":"publisher","first-page":"1473","DOI":"10.1001\/jama.2026.3088","article-title":"FDA\u2019s regulatory reforms to unlock competition and lower drug costs: breaking the biosimilar bottleneck.","volume":"335","author":"Makary","year":"2026","journal-title":"JAMA"},{"issue":"4","key":"coi260047r8","doi-asserted-by":"publisher","first-page":"647","DOI":"10.1002\/hec.4471","article-title":"Biosimilar competition: early learning.","volume":"31","author":"Frank","year":"2022","journal-title":"Health Econ"},{"issue":"5","key":"coi260047r9","doi-asserted-by":"publisher","first-page":"742","DOI":"10.1016\/j.jval.2025.02.008","article-title":"The price effects of biosimilars in the United States.","volume":"28","author":"Jofre-Bonet","year":"2025","journal-title":"Value Health"},{"issue":"16","key":"coi260047r11","doi-asserted-by":"publisher","first-page":"4292","DOI":"10.1007\/s11606-022-07670-7","article-title":"Uptake and competition among biosimilar biological products in the US Medicare fee-for-service population.","volume":"37","author":"Kozlowski","year":"2022","journal-title":"J Gen Intern Med"},{"issue":"6","key":"coi260047r12","doi-asserted-by":"publisher","first-page":"989","DOI":"10.1377\/hlthaff.2020.02239","article-title":"Biosimilars and follow-on products in the United States: adoption, prices, and users.","volume":"40","author":"Stern","year":"2021","journal-title":"Health Aff (Millwood)"},{"issue":"14","key":"coi260047r13","doi-asserted-by":"publisher","first-page":"806","DOI":"10.1093\/ajhp\/zxaf092","article-title":"National trends in prescription drug expenditures and projections for 2025.","volume":"82","author":"Tichy","year":"2025","journal-title":"Am J Health Syst Pharm"},{"issue":"2","key":"coi260047r14","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1001\/jamaoncol.2017.2004","article-title":"Biosimilars in oncology in the United States: a review.","volume":"4","author":"Nabhan","year":"2018","journal-title":"JAMA Oncol"},{"issue":"4","key":"coi260047r15","doi-asserted-by":"publisher","first-page":"605","DOI":"10.1007\/s40258-021-00637-5","article-title":"Does biosimilar bevacizumab offer affordable treatment options for cancer patients in the USA? a budget impact analysis from US commercial and Medicare payer perspectives.","volume":"19","author":"Yang","year":"2021","journal-title":"Appl Health Econ Health Policy"},{"issue":"8","key":"coi260047r16","doi-asserted-by":"publisher","first-page":"573","DOI":"10.7326\/0003-4819-147-8-200710160-00010","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies.","volume":"147","author":"von Elm","year":"2007","journal-title":"Ann Intern Med"},{"issue":"11","key":"coi260047r17","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.34463","article-title":"Promoting biosimilar competition by revising Medicare reimbursement rules.","volume":"4","author":"Rome","year":"2021","journal-title":"JAMA Netw Open"},{"issue":"8","key":"coi260047r19","doi-asserted-by":"publisher","first-page":"1159","DOI":"10.1377\/hlthaff.2023.01215","article-title":"Biosimilar uptake in the US: patient and prescriber factors.","volume":"43","author":"Hong","year":"2024","journal-title":"Health Aff (Millwood)"},{"issue":"1","key":"coi260047r21","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1377\/hlthaff.2009.0060","article-title":"Group insurance: a better deal for most people than individual plans.","volume":"29","author":"McDevitt","year":"2010","journal-title":"Health Aff (Millwood)"},{"issue":"6","key":"coi260047r22","doi-asserted-by":"publisher","first-page":"779","DOI":"10.1377\/hlthaff.2022.01448","article-title":"Cancer drug trastuzumab and its biosimilars compete on price for market share.","volume":"42","author":"Chen","year":"2023","journal-title":"Health Aff (Millwood)"},{"issue":"11","key":"coi260047r23","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2025.42937","article-title":"Biologic drug prices in Medicare Part B after entry of biosimilars to the market.","volume":"8","author":"Abdelaziz","year":"2025","journal-title":"JAMA Netw Open"},{"issue":"14","key":"coi260047r24","doi-asserted-by":"publisher","first-page":"1243","DOI":"10.1001\/jama.2026.1777","article-title":"Hospital adoption and pricing for oncology biosimilars.","volume":"335","author":"Robinson","year":"2026","journal-title":"JAMA"},{"issue":"10","key":"coi260047r26","doi-asserted-by":"publisher","first-page":"636","DOI":"10.1097\/MLR.0000000000001906","article-title":"Uptake of biosimilar among privately insured patients undergoing infliximab treatment.","volume":"61","author":"Chang","year":"2023","journal-title":"Med Care"},{"issue":"1","key":"coi260047r27","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1002\/cpt.2763","article-title":"Patient out-of-pocket costs following the availability of biosimilar versions of infliximab.","volume":"113","author":"Feng","year":"2023","journal-title":"Clin Pharmacol Ther"},{"issue":"12","key":"coi260047r28","doi-asserted-by":"publisher","first-page":"1599","DOI":"10.1016\/j.jval.2020.06.014","article-title":"Association between filgrastim biosimilar availability and changes in claim payments and patient out-of-pocket costs for biologic filgrastim products.","volume":"23","author":"Mouslim","year":"2020","journal-title":"Value Health"},{"issue":"7","key":"coi260047r29","doi-asserted-by":"publisher","first-page":"795","DOI":"10.18553\/jmcp.2022.28.7.795","article-title":"Patient out-of-pocket and payer costs for pegfilgrastim originator vs biosimilars as primary prophylaxis of febrile neutropenia in the first cycle among a commercially insured population.","volume":"28","author":"Wang","year":"2022","journal-title":"J Manag Care Spec Pharm"},{"issue":"3","key":"coi260047r30","doi-asserted-by":"publisher","DOI":"10.1001\/jamahealthforum.2023.5429","article-title":"Patient out-of-pocket costs for biologic drugs after biosimilar competition.","volume":"5","author":"Feng","year":"2024","journal-title":"JAMA Health Forum"},{"issue":"1","key":"coi260047r31","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2025.54235","article-title":"Out-of-pocket spending for biologic drugs after biosimilar competition for Medicare patients.","volume":"9","author":"Riegler","year":"2026","journal-title":"JAMA Netw Open"},{"key":"coi260047r4","unstructured":"US Congress. Biologics Price Competition and Innovation Act of 2009. Accessed September 10, 2025. https:\/\/www.congress.gov\/111\/plaws\/publ148\/PLAW-111publ148.pdf"},{"key":"coi260047r6","unstructured":"US House of Representatives. 42 USC 262: regulation of biological products. Accessed September 10, 2025. https:\/\/uscode.house.gov\/view.xhtml?req=(title:42%20section:262%20edition:prelim)"},{"key":"coi260047r7","unstructured":"Center for Biosimilars. Biosimilar approvals. Accessed April 29, 2025. https:\/\/www.centerforbiosimilars.com\/biosimilar-approvals"},{"key":"coi260047r10","unstructured":"Chang? J, Sen? A. Uptake of biosimilars remains low among people with employer-sponsored insurance. Accessed August 7, 2025. https:\/\/healthcostinstitute.org\/hcci-originals-dropdown\/all-hcci-reports\/uptake-of-biosimilars-remains-low-among-people-with-employer-sponsored-insurance"},{"key":"coi260047r18","unstructured":"US Centers for Medicare & Medicaid Services. Medicare Part B drug average sales price. Accessed April 19, 2024. https:\/\/www.cms.gov\/medicare\/payment\/fee-for-service-providers\/part-b-drugs\/average-drug-sales-price"},{"key":"coi260047r20","doi-asserted-by":"crossref","unstructured":"US Bureau of Labor Statistics. Consumer Price Index (CPI) databases. Accessed August 29, 2025. https:\/\/www.bls.gov\/cpi\/data.htm","DOI":"10.69645\/DSDC8304"},{"key":"coi260047r25","unstructured":"US Department of Health and Human Services. Medicare Part B enrollee use and spending on biosimilars, 2018-2023. Accessed September 10, 2025. https:\/\/aspe.hhs.gov\/reports\/biosimilars-medicare-part-b"}],"container-title":["JAMA Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamaoncology\/articlepdf\/2853307\/jamaoncology_liu_2026_oi_260047_1792007353.32084.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T15:00:47Z","timestamp":1792076447000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamaoncology\/fullarticle\/2853307"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,1]]},"references-count":31,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamaoncol.2026.3128","relation":{},"ISSN":["2374-2437"],"issn-type":[{"value":"2374-2437","type":"print"}],"subject":[],"published":{"date-parts":[[2026,10,1]]}}}