OBJECTIVES : To provide a comparison of the magnitude of price discounts offered by several biosimilars in the US, UK, Norway, Spain, Germany, Brazil, Argentina and Colombia, and the difference between the existence of one or more biosimilar versions available.

METHODS : The list price of several biologics and respective biosimilars was used for European countries, Brazil and Argentina; wholesaler price in Colombia and the National Average Drug Acquisition Cost, Veteran Affairs prices and Medicaid payment limits in the US. Data was extracted from national price databases.

RESULTS : List-price discounts in European countries, which have the lowest originator price among the countries analysed, vary throughout countries, from 5-15% in the UK to 20-45% in Germany. The introduction of a second biosimilar in EU countries resulted in similar discounts to that of the first (in some cases in the UK and Spain, the same discount). In contrast, in the US, Brazil and Colombia, the second biosimilar introduced a further 10% discount. Furthermore, in the US a second biosimilar also reduces the Medicaid payment limit for the first version. In addition, US list-price discounts for biosimilars reach 35%, but only 12% for Medicaid. In Brazil, infliximab biosimilars offer a discount greater than 45%, and those of insulin glargine have achieved roughly 70% discount in Brazil and Colombia. However, despite the large discounts negotiated in these LatAm countries, some biosimilars are still priced higher than in the UK or Norway.

CONCLUSIONS : The discount provided by biosimilars upon entry varies greatly by region, and it could be influenced by the originator price (and indirectly, by price-setting regulations governing the originator), the presence of other versions in the market (e.g. biosimilars share Medicaid’s code and payment limit, which may favor prescribing of the cheapest biosimilar) and even regulatory tools, such as mandatory discounts or reference pricing that includes the originator.