Biologics are some of the most expensive drugs on the market. A single year’s supply of Humira can cost over $70,000. For patients with autoimmune diseases like rheumatoid arthritis or Crohn’s, that’s not just a bill-it’s a barrier to staying alive and functional. But in recent years, a new option has quietly entered the scene: biosimilars. These aren’t generics. They’re not exact copies. But they’re close enough to work the same way-and they’re cutting costs dramatically.
What Exactly Are Biosimilars?
Biosimilars are medicines made from living cells, just like the original biologics they’re based on. Think of them like a very close twin, not a photocopy. The original biologic, say, Humira (adalimumab), is made using complex biological processes involving living cells in a lab. Replicating that perfectly? Impossible. But you can get so close that the FDA says there’s no meaningful difference in safety or effectiveness.
That’s different from generics. A generic pill for, say, high blood pressure, is made of simple chemicals. You can recreate it exactly. Biosimilars? They’re like building a Ferrari using the same blueprints but different tools and materials. The car drives the same, but the engine isn’t identical. That’s why biosimilars cost less-but not as much less as generics.
How Much Do Biosimilars Actually Save?
The numbers speak for themselves. In 2024, biosimilars saved the U.S. healthcare system $20.2 billion. Since the first one hit the market in 2015, total savings have reached $56.2 billion. That’s not pocket change. That’s money that could fund hundreds of thousands of other treatments.
When biosimilars first came out, savings were modest-around 15%. But now? It’s different. For Humira, which had been the top-selling drug in the world, ten biosimilars entered the market in 2023. By January 2025, list prices dropped by up to 85%. That’s huge. But here’s the catch: list price isn’t what you pay. The real savings come after rebates, contracts, and pharmacy benefit manager deals.
Still, patients are seeing real relief. In commercial insurance plans, out-of-pocket costs for biosimilars are 23% lower on average than for the original biologic. For employers, switching just two biologics to biosimilars saved $1.4 billion across self-insured companies in one year. One employee switching from Humira to its biosimilar could save their employer over $1.5 million over time.
Why Don’t Biosimilars Save More Than Generics?
Generics can slash prices by 80-90%. Biosimilars? Typically 30-40%. Why the gap?
It’s the science. Biologics are made from living organisms-cells, proteins, antibodies. The manufacturing process is incredibly complex. One tiny change in temperature, pH, or cell line can alter the final product. That means biosimilar makers must run massive clinical trials to prove their version works just as well. Generics? They just prove chemical equivalence. No need for 10,000 patient studies.
That complexity drives up development costs. A biosimilar can cost $100-$200 million to bring to market. A generic? Maybe $2 million. So while biosimilars are cheaper, they’re not cheap to make. That’s why savings plateau around 35% on average for medical benefits-though some, like Stelara biosimilars, have hit 90% off list price.
The Humira Example: A Case Study in Savings
Humira was the king of biologics. For over a decade, it brought in over $20 billion a year for AbbVie. No competition. No pressure to lower prices.
Then came the biosimilars. In 2023, after years of patent battles, ten biosimilars launched in the U.S. overnight. List prices dropped 80-85%. But here’s what happened next: AbbVie didn’t just sit back. They slashed their own prices and offered massive rebates to pharmacy benefit managers (PBMs). Suddenly, the net price-what insurers actually paid-didn’t drop as much.
That’s the rebate trap. PBMs often favor the original drug because it pays them a bigger cut. So even if the biosimilar is cheaper on the shelf, the rebate deal makes the originator look like the better buy. It’s a system designed to protect profits, not patients.
But patients still win. Out-of-pocket costs dropped. Employers saw lower premiums. Medicare Part B prices fell consistently after biosimilars entered. And for the first time, patients who couldn’t afford Humira could now access a treatment that works just as well.
Why Adoption Is Still So Low
Despite the savings, originator biologics still control 98.9% of biologics spending in the U.S. That’s not a typo. Less than 2% of the market is using biosimilars.
Why? Three big reasons:
- Rebate systems favor originators, even when biosimilars are cheaper.
- Doctor and patient hesitation. Many still think biosimilars are "inferior" or "experimental." They’re not. They’ve been used safely in Europe for over 15 years.
- Slow formulary changes. Health plans don’t update their drug lists fast enough. Some still require patients to try the expensive version first.
Compare that to Europe. In Norway, 86% of patients on Humira use the biosimilar. In the U.S.? Less than 10%. Why? Europe has price controls. The U.S. has market chaos.
The Biosimilar Void: A 4 Billion Problem
Here’s the scary part. Over the next 10 years, 118 biologics will lose patent protection. Only 12 of them have biosimilars in development. That means 90% of upcoming biologics won’t face competition.
That’s a $234 billion opportunity lost. Imagine if every biologic had a biosimilar. We could cut drug spending in half for millions of patients with cancer, diabetes, and autoimmune diseases.
Right now, the U.S. is falling behind. The EU has biosimilars in development for 73% of high-sales biologics. The U.S.? Only 23%. Why? Because the regulatory path is longer, the market is harder to penetrate, and big pharma fights hard to keep their monopoly.
How to Get More Savings-For Patients and Plans
Real savings won’t happen by accident. They need action.
- Formulary positioning: Health plans should put biosimilars first-no step therapy required.
- Education: Doctors and patients need clear info: biosimilars are safe, effective, and approved by the FDA.
- Contract transparency: Employers and insurers must demand net price data, not just list prices. Rebates should be shared with patients.
- Policy change: The FDA has made progress streamlining approval. But Congress needs to limit rebate abuse and require biosimilar substitution without extra hurdles.
Some employers are already doing it. One large tech company switched all employees on Humira to biosimilars. They saved $2.3 million in one year. Patient satisfaction stayed the same. No side effects spiked. No drop in effectiveness.
The Future Is Here-But It’s Not Automatic
Biosimilars aren’t a future idea. They’re here now. And they’re saving billions. But without smarter policies, better education, and fairer contracts, their potential will stay locked away.
The science is proven. The savings are real. The only thing missing is the will to use them.
If you’re on a biologic right now, ask your doctor: Is there a biosimilar? If you’re an employer or plan sponsor, ask your PBM: Why are we still paying full price for the originator? The answer might surprise you.
Are biosimilars as safe as the original biologics?
Yes. The FDA requires biosimilars to show no clinically meaningful differences in safety, purity, or potency compared to the original. Over 3.3 billion days of patient use since 2015 have shown no unique safety concerns. In Europe, biosimilars have been used safely for over 15 years.
Why are biosimilars cheaper if they’re so complex to make?
They’re cheaper because they don’t need to repeat the full clinical trials the original drug went through. The original manufacturer spent billions proving safety and effectiveness. Biosimilar makers build on that data, cutting development time and cost. They still face high manufacturing costs, but they avoid the $1-$2 billion price tag of launching a brand-new biologic.
Can I switch from a biologic to a biosimilar safely?
Yes, if your doctor approves it. Many biosimilars are now designated as "interchangeable" by the FDA, meaning pharmacists can substitute them without asking your doctor. Studies show no loss in effectiveness or increase in side effects when switching. Millions of patients have done it without issue.
Do biosimilars work for all biologics?
Not yet. As of 2025, biosimilars are available for only about 12 of the hundreds of biologics on the market. But more are coming. Key targets include Enbrel, Neulasta, and Rituxan. If you’re on a biologic, ask your provider or pharmacist if a biosimilar exists for your medication.
Why doesn’t my insurance cover biosimilars?
Many insurers still favor originator drugs because of rebate deals with big pharma. Even if the biosimilar is cheaper, the rebate on the original can make it look like the better financial choice for the insurer-not the patient. You can ask your plan to change its formulary or appeal a denial. Patient advocacy groups can help.
