Biosimilar Cost Savings: How They Compare to Original Biologic Prices

Why biosimilars matter more than you think

Imagine a life-saving drug that costs $20,000 a year. Now imagine the same treatment, just as safe and effective, costing $3,000. That’s not science fiction-it’s what biosimilars are doing right now in the U.S. healthcare system. Biosimilars aren’t generics. They’re not exact copies like the cheap pills you get for high blood pressure or cholesterol. Instead, they’re highly similar versions of complex biologic drugs-medicines made from living cells, used to treat cancer, autoimmune diseases, and other serious conditions. And they’re saving patients, employers, and the whole system billions.

As of January 2025, 10 FDA-approved biosimilars are available for Humira (adalimumab), the top-selling biologic in history. Some are priced up to 85% below the original list price. Yet, even with that kind of discount, originator biologics still control over 98% of spending. Why? Because the system isn’t built to reward savings-it’s built to protect them.

Biosimilars vs. generics: The big difference

When a brand-name pill like Lipitor loses its patent, a generic version can be made in a lab using simple chemistry. The active ingredient is identical. The pill looks the same. The cost drops 80-90% overnight.

Biosimilars are different. They’re made from living cells-like yeast or hamster ovary cells-grown in giant bioreactors. Tiny changes in temperature, pH, or nutrients can alter the final product. That’s why biosimilars can’t be exact copies. They’re “highly similar,” with no clinically meaningful differences in safety or effectiveness. But because they’re so complex to make, development costs are much higher. That’s why their savings are usually 15-35% off the list price, not 80%.

That doesn’t mean they’re not powerful. It just means their impact works differently. Instead of one big price drop, biosimilars create steady pressure. As more enter the market, prices keep falling. The first Humira biosimilar cut prices by 30%. By 2025, with 10 options, some were selling for 85% less than the original list price.

Real savings, real numbers

The numbers don’t lie. In 2024 alone, biosimilars saved the U.S. healthcare system $20.2 billion. Since 2015, that total hits $56.2 billion. For perspective, that’s enough to cover the annual cost of insulin for every diabetic in Australia for nearly five years.

Take Humira again. Before biosimilars, it cost about $7,000 per month. Today, list prices for biosimilars range from $1,000 to $1,500. That’s an 85% drop. But here’s the catch: most patients don’t pay list price. Insurance and rebates muddy the waters. The actual net price-the amount insurers pay after rebates-is often much closer to the original. That’s why some patients still pay hundreds a month, even with a biosimilar.

But when you look at out-of-pocket costs, the picture changes. A 2025 study by CSRxP found that patients on biosimilars paid 23% less on average than those on the original biologic. For someone paying $500 a month for Humira, that’s $115 saved every month. That’s a car payment. Or groceries for a family for weeks.

Employers are seeing the same trend. One company saved $1.53 million in a single year just by switching all employees on Humira to a biosimilar. Across all self-insured U.S. employers, switching just two biologics to biosimilars could save $1.4 billion annually.

Why aren’t more people using them?

If biosimilars save money and work just as well, why do originator biologics still make up 98.9% of spending? The answer isn’t science-it’s money.

Big drugmakers use something called the “rebate trap.” They pay huge rebates to pharmacy benefit managers (PBMs) to keep their drug on the preferred list. Even if a biosimilar is cheaper, the rebate makes the originator look like the better deal on paper. PBMs, in turn, often push their own private-label biosimilars, which aren’t always the cheapest option.

Doctors and patients also have doubts. Some still think biosimilars are “second-rate.” But over 3.3 billion days of therapy have been given with biosimilars since 2015-with zero unique safety issues. The FDA and European regulators agree: they’re just as safe.

Then there’s the “biosimilar void.” Of the 118 biologics expected to lose patent protection over the next 10 years, only 12 have biosimilars in development. That means 90% of future savings are at risk. In Europe, 73% of high-sales biologics had biosimilars in the pipeline. In the U.S.? Just 23%.

How to get the most savings

If you’re an employer, insurer, or just someone paying for treatment, here’s how to unlock savings:

1. Check your formulary. Ask your insurer or pharmacy benefit manager: Which biosimilars are covered? Are they preferred over the originator?
2. Ask for step therapy. Many plans now require you to try a biosimilar first before approving the original. If yours doesn’t, ask your doctor to request it.
3. Compare out-of-pocket costs. Don’t trust the list price. Ask your pharmacy for the final price after insurance and any coupons.
4. Push for education. If your doctor is hesitant, ask for the latest clinical data. Studies in JAMA Network Open show biosimilar prices keep dropping over time after they enter the market.

For employers and health plans, the real win comes from contracts. Negotiate with PBMs to reduce rebates on originators and tie payments to biosimilar use. Use data tools like Segal’s SHAPE warehouse to track spending and spot where savings are being lost.

The bigger picture

Biologics are the most expensive drugs on the market. They treat cancer, rheumatoid arthritis, Crohn’s disease, psoriasis-conditions that can be life-altering. Without biosimilars, these drugs stay out of reach for millions.

But the U.S. is falling behind. Countries like Norway have over 80% biosimilar use for some drugs within three years. Here, adoption is slow. Why? Because the system rewards complexity over savings. Rebates, formulary games, and lack of policy pressure keep prices high.

There’s hope. The FDA has streamlined approval. The Inflation Reduction Act is pushing Medicare to negotiate prices. And in April 2025, the Biden administration made biosimilar competition a priority.

The math is simple: more biosimilars = lower prices = more patients treated. Right now, we’re leaving $234 billion in savings on the table over the next decade. That’s not a small gap. That’s a crisis in access.

Biosimilars aren’t perfect. But they’re the most powerful tool we have right now to bring down the cost of the most expensive medicines in modern medicine. The question isn’t whether they work. It’s whether we’ll let them.

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