Biosimilars: Helping Lower Cancer Drug Costs

Cancer treatment can bring enough uncertainty without worrying about how to pay for it. If your oncologist recommends a medicine called a biosimilar, you may wonder: Will it work as well? Why does it cost less? Will my insurance cover it?

Biosimilar cancer drugs can offer the same treatment benefits as the original medicine, sometimes at a lower cost. Here’s what that means for your care – and how our oncology team uses an on-site pharmacy to support timely, personalized treatment.

What is a biosimilar?

Some cancer medicines are biologics, drugs made using living cells. To learn more about these treatments, read our guide, What to Expect With Biologic or Monoclonal Antibody Treatment.

A biosimilar is a highly similar version of an existing biologic medicine. Before approving it, the U.S. Food and Drug Administration (FDA) must confirm that it has no meaningful differences in safety or effectiveness compared with the original biologic. In plain language, you can expect the same treatment benefits and risks.

Biosimilar versions are available for several medicines used in cancer care, including Herceptin®, Avastin®, Rituxan® and Neulasta®. Some treat cancer itself, while others help support you during treatment.

Why can biosimilar cancer drugs cost less?

A lower price does not mean lower-quality treatment.

Companies making biosimilars can build on what researchers already know about the original medicine. That can reduce development costs. Having more treatment options also creates competition, which may help lower the cost of cancer drugs.

But a lower drug price does not always mean a lower bill for you. Before treatment starts, ask your insurer:

• Does my plan cover the recommended medicine?
• What might I need to pay myself?
• Could a covered biosimilar cost me less?

If those costs are difficult to manage, ask our team where you can learn about possible financial assistance. The goal is to understand your likely cost – not assume that one option will always be the least expensive.

How our on-site pharmacy supports timely, personalized treatment

At Personalized Hematology-Oncology, your cancer care is led by our board-certified oncologist, Dr. Antonio Castillos. Our on-site pharmacy supports that care by working directly with him and our oncology team to prepare treatment for your specific needs.

Your cancer treatment needs may change from one visit to the next. Dr. Castillos may need to adjust your dose based on your blood tests, weight or how you’re feeling. That can become more complicated when your insurer requires an outside pharmacy to ship your infusion medicine to the office. This arrangement is called “white bagging.”

If the medicine arrives late or your dose changes after it has been ordered, your treatment could be delayed while our team arranges the correct supply.

With infusion medicines prepared on-site, our oncology team can coordinate directly with our pharmacy when Dr. Castillos changes your treatment plan. That close communication helps our pharmacy prepare the prescribed dose with more flexibility than a shipment ordered in advance.

Having an on-site pharmacy does not remove every insurance or scheduling hurdle. It gives our oncology team more flexibility to respond to changes and helps keep your treatment coordinated in one place.

If your insurer requires an outside pharmacy, ask our team how that requirement could affect your treatment schedule.

How we help you explore lower cancer drug costs

If our oncology team recommends a biosimilar medicine, we can help you identify questions to ask your insurer about coverage requirements and what you might pay.

If the expected cost is difficult to manage, let us know. We can help you explore possible financial assistance and understand where to turn for more information.

Your insurer can explain your plan’s coverage and benefits. While we cannot promise a specific price or insurance decision, we can offer guidance on finding lower cancer drug costs.

Personalized care, whichever medicine you receive

A different medicine name should not leave you with unanswered questions.

FDA-approved biosimilars provide the same expected benefits and risks as the original medicines they are compared with. If Dr. Castillos recommends one, he and our oncology team can explain why it is right for your treatment and what, if anything, will change at your visits.

Whether you receive the original medicine or a biosimilar, Dr. Castillos guides your treatment. Our nurses and on-site pharmacy work with him to carry out that plan and respond as your needs change.

These questions can help start the conversation:

• Is a biosimilar available for my treatment?
• Why do you recommend this medicine?
• What will my insurance cover, and what might I pay?
• Can my medicine be prepared on-site, or does my insurer require an outside pharmacy?

Taking cancer medicine by mouth? Read how our oncology team and on-site pharmacy work together to support patients in Oral Oncology: Managing Oral Chemotherapy at Home.

Talk with our cancer care team about your treatment and cost concerns. We’ll help you understand your options and next steps, with care built around your individual needs.