Medicare Part D plans could switch the coverage status of a reference biologic midyear if the plan adds a biosimilar for that product to the formulary, under an amendment added to the Senate Finance Committee’s pharmacy benefit manager reform package, which cleared the committee on a 26-1 vote 26 July.
Biosimilars Could Give Brands the Boot Mid-Year Under Amendment Added to Senate PBM Reform Bill
However, the low CBO score attached to the measure may suggest PBMs might not be incentivized to follow through on the congressional permission.
