Healthcare

Ensuring a level playing field for a leading manufacturer of branded biological products

Challenge

When one of the world’s largest biopharmaceutical companies was faced with an extension of a transitional pass-through payment program under Medicare that would have given biosimilar competitors an unfair advantage, they enlisted the help of Roberti Global.

Action

Engaged and educated lawmakers in House and Senate leadership, as well as those serving on relevant committees of jurisdiction, on the history of the pass-through program (e.g., its limited application to innovator products) and the perverse incentives created by its application to biosimilars (e.g., encouraging hospitals to use biosimilars even in cases where the branded biologic is the better and lower cost option).

Results

Roberti Global successfully limited the scope of the extension such that the pass-through payments inured to the benefit of only a handful of products – none of which were competing biosimilars.

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