The Biosimilars Forum announced its support for a letter from Congress members to Andrew Slavitt, acting administrator for CMS, regarding proposed provisions for the assignment of billing codes to biosimilars. The letter was cosigned by House Energy and Commerce Committee members Reps. Joe Barton (R-Tex.) and Anna Eshoo (D-Calif.) and a delegation of 33 House members.
Under the current proposal, biosimilars manufactured by different companies would all receive one billing code in the 2016 Medicare Physician Fee Schedule.
“We are pleased that this issue has quickly attracted the interest of Congress and applaud the House members who are working to correct the proposed regulation to reflect the [Biologics Price Competition and Innovation Act of 2009 (BPCIA)]'s biosimilar payment and coding requirements,” Michael Werner, Biosimilars Forum policy advisor, stated in a press release. “We urge CMS to revise its proposed rule for Part B to better reflect the law and to support this new industry by giving each biosimilar of the same reference product its own, unique Medicare claims code and payment amount.”
According to the letter, the rule “treats biosimilars as if they were generic drugs” yet are complex molecules often developed in living organisms. Without a unique identifier, adverse events may not receive proper attribution, according to the release.
“The Biosimilars Forum is deeply concerned that the provisions for biosimilars in the proposed rule may limit the future treatment options health care professionals would be able to offer their patients,” Werner stated. “If this proposed rule is adopted as currently written, we fear that thousands of patients facing serious diseases and disorders who are expected to benefit from biosimilars may have limited access to these therapies.”