Biosimilar Cost Savings: How They Compare to Original Biologic Prices

When you hear the word biosimilar, you might think it’s just another generic drug. But it’s not. Biosimilars aren’t copies like the pills you pick up for high blood pressure or cholesterol. They’re complex medicines made from living cells-like the biologics they’re based on-and getting them to market is a whole different ballgame. Yet, they’re saving patients and healthcare systems billions. The question isn’t whether they work-it’s why they’re still not used more, and how much you’re really saving when you switch.

Why Biosimilars Aren’t Like Generics

Generic drugs are simple. They’re chemically identical to brand-name pills. If you take a generic lisinopril, it’s the same molecule as the brand version. Biosimilars? Not even close. They’re made from living organisms-bacteria, yeast, or mammalian cells-grown in huge bioreactors. Even tiny changes in temperature, pH, or nutrient mix can alter the final product. That’s why the FDA doesn’t call them “identical.” They call them “highly similar.” This complexity drives up costs. Developing a biosimilar takes 8-10 years and can cost $100-$200 million. Generics? Often under $5 million. That’s why biosimilars don’t slash prices by 80-90% like generics do. But they still cut costs hard. In 2024, biosimilars saved the U.S. healthcare system $20.2 billion. Since 2015, that total hits $56.2 billion. That’s not pocket change. That’s enough to cover cancer treatments for hundreds of thousands of people who couldn’t afford them before.

Real-World Savings: Humira and Stelara

The biggest success story? Humira (adalimumab). For years, it was the top-selling drug in the world, costing over $7,000 per month. When the first biosimilars hit the market in 2023, list prices dropped by up to 85%. That sounds amazing-until you dig into the rebate system. Pharmaceutical companies pay huge rebates to pharmacy benefit managers (PBMs), which can make the net price of the original drug almost match the biosimilar’s list price. So while the sticker price looks low, the real savings depend on how your plan negotiates. Still, patients feel it. In commercial insurance, out-of-pocket costs for biosimilars are 23% lower on average than for the originator. For Humira biosimilars, some patients saw their monthly copay drop from $150 to $30. That’s life-changing for someone managing rheumatoid arthritis or Crohn’s disease. Stelara (ustekinumab) followed a similar path. Nine biosimilars launched in 2025, with list prices as much as 90% below the original. Medicare Part B data shows prices kept falling after each new biosimilar entered the market. The more competitors, the harder the price pressure. One study found that if a second biosimilar enters within three years of the first, average sales prices drop nearly twice as fast.

The Biosimilar Void: A $234 Billion Missed Opportunity

Here’s the scary part: 90% of biologics set to lose patent protection in the next decade don’t have a single biosimilar in development. That’s 118 drugs-many of them for cancer, autoimmune diseases, and rare conditions-facing no competition. In the EU, 73% of high-sales biologics have biosimilars in the pipeline. In the U.S.? Only 23%. Why? Because developing biosimilars is risky. The regulatory path is long. The market is dominated by originator companies with deep pockets and aggressive patent strategies. If the U.S. filled this gap, it could save $234 billion over the next ten years. That’s more than the entire annual budget of the CDC. But right now, the pipeline is empty. And without new biosimilars, prices for older biologics won’t budge. Patients will keep paying $10,000 a year for drugs that could cost $2,000-if only someone built the biosimilar.

Who’s Saving Money-and Who’s Not

Employers are seeing real savings. One company reported $1.53 million saved per year when all employees switched from a biologic to its biosimilar. Across all self-insured U.S. employers, switching just two biologics to biosimilars could save $1.4 billion. That’s money that can go toward better benefits, lower premiums, or hiring more staff. But not everyone wins. PBMs sometimes push private-label biosimilars-ones they own or have exclusive deals with-over other options. That’s not bad in theory, but it limits choice. If your plan only covers one biosimilar, you’re not getting the full benefit of competition. Doctors and patients may also hesitate. Many still believe biosimilars are “less effective,” even though studies show no difference in safety or outcomes. A 2024 JAMA Network Open review confirmed: biosimilar prices were lower at every point after launch, and kept falling over time.

How to Get the Most Savings

If you’re an employer, a plan sponsor, or even a patient trying to save money, here’s what works:

• Push for formulary placement. Make biosimilars the first-line option, not the last resort.
• Use step therapy. Require patients to try the biosimilar before approving the original biologic.
• Look beyond list price. Demand transparency on net prices after rebates. A drug with a $5,000 list price might cost $3,500 after rebates-while a biosimilar with a $3,000 list price might cost $2,800 net. The biosimilar still wins.
• Educate providers and patients. Many doctors don’t know biosimilars are just as safe. Many patients fear switching. Clear, simple messaging helps.

It takes 6-12 months to fully integrate these changes into pharmacy benefit systems. But once they’re in place, the savings stick. And they compound.

What’s Next? Policy, Pressure, and Progress

The Biden administration’s 2024 executive order on drug pricing specifically called out biosimilars as a key tool to lower costs. The FDA has streamlined approval pathways. In April 2025, CSRxP praised recent federal commitments to boosting competition. But policy alone won’t fix the pipeline gap. We need incentives for manufacturers to invest in biosimilars for less profitable drugs-like those for rare diseases. We need clearer rules on rebate transparency. We need state-level policies that encourage substitution. Meanwhile, countries like Norway have already shown what’s possible. Within three years of a biosimilar launch, 86% of patients there switched to it. The U.S. is nowhere near that. But it doesn’t have to stay that way.

The Bottom Line

Biosimilars aren’t magic. They won’t cut every biologic’s price in half overnight. But they’re the only real tool we have to bring down the cost of life-saving medicines that have been priced beyond reach for too long. The savings are real-$20 billion last year alone. The potential is enormous-$234 billion over ten years. The only thing missing is the will to act. If you’re paying for biologics now, ask your pharmacist: Is there a biosimilar? Is it covered? How much will it save you? The answer might surprise you.