Physician office payment for biosimilars in Medicare Part B in 2019

This statistic shows a hypothetical example of physician office payments for biosimilars in Medicare Part B as of 2019. The wholesale acquisition cost (WAC) for the reference drug would be one thousand U.S. dollars, while the WAC for biosimilar A would be 200 dollars lower.

Example of physician office payment for biosimilars in Medicare Part B as of 2019 (in U.S. dollars)*

WAC (list price)ASP6% of reference product’s ASPPayment rate, ASP + 6% (before sequestration)Payment rate, ASP + 4.3% (after sequestration)Patient cost-share (20%)
Reference1,00080048848834.4169.6
Biosimilar A80064048688674.4137.6
Biosimilar B70056048608594.4121.6
You need to log in to download this statistic
Register for free
Already a member?
Log in
Show detailed source information?
Register for free
Already a member?
Log in
Sources

Release date

2019

Region

United States

Survey time period

as of 2019

Supplementary notes

* This hypothetical example assumes that the reference biologic’s ASP (average sales price) is 20% less than the WAC (wholesale acquisition cost) based on rebates over time.
** Sequestration lowers the 80% Medicare payment to physicians by 2%, but the beneficiary copayment remains at 20% of the original payment rate of ASP+6%.

Statista Accounts: Access All Statistics. Starting from $708 / Year
Basic Account
Get to know the platform

You only have access to basic statistics.

Premium Account
Your perfect start with Statista
  • Instant access to 1m statistics
  • Download in XLS, PDF & PNG format
  • Detailed references

$59 / Month *

Corporate Account
Full access

Corporate solution including all features.

* All products require an annual contract.
   Prices do not include sales tax.

Statistics on "Generics and biosimilars"

Statista Accounts: Access All Statistics. Starting from $708 / Year
Learn more about how Statista can support your business.