What question did this study set out to answer?

To investigate the association between biosimilar competition and out-of-pocket spending for Medicare patients using biologics.

January 17, 2026JAMA Network OpenOpen Access

Out-of-Pocket Spending for Biologic Drugs After Biosimilar Competition for Medicare Patients

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To investigate the association between biosimilar competition and out-of-pocket spending for Medicare patients using biologics.
Cross-sectional study design
Analyzed data from a national commercial claims database (Optum)
Participants included Medicare Advantage members using 7 specific biologics from 2009 to 2022
Two-part regression models estimated mean annual out-of-pocket spending, adjusted for demographics and clinical factors
Mean annual out-of-pocket costs decreased by $94 after biosimilar competition
Costs fell from $233 to $165 four years post-competition
Decreases in costs were more significant for patients who paid coinsurance or deductibles
Only 40.8% of patients paid no out-of-pocket costs at all

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Cross-sectional study examines lower out-of-pocket spending for Medicare patients using biologics, suggesting improved access due to biosimilars.

Riegler et al. (2026) studied this question.

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Cross-sectional study examines lower out-of-pocket spending for Medicare patients using biologics, suggesting improved access due to biosimilars.