Physician practices say stable reimbursement is key to expanding biosimilar use

Physician practices reported that stable and predictable reimbursement is essential for long-term biosimilar use, according to the 2026 Biosimilars Report released today by Cardinal Health. For instance, 68% of surveyed practices rated predictable reimbursement as very important, while 59% said they prefer set discount models over gradual price increases.

These findings suggest that payment stability could be just as important as clinical confidence in driving the next phase of biosimilar adoption.

Biosimilars have already generated more than $56 billion in healthcare savings since 2015 and are projected to deliver up to $181 billion in additional savings over the next few years, the report shared. Although biologics account for just 5% of prescription volume, they represent 50% of total drug spending.

That imbalance makes biosimilar adoption a key strategy for payers and health systems seeking to manage specialty drug costs while maintaining access and quality.

A recent report from the Association for Accessible Medicines found that biosimilars generated $20.2 billion in savings in 2024 alone and $56.2 billion since the first biosimilar entered the U.S. market in 2015. The FDA has also reported that approved biosimilars meet the same safety and effectiveness standards as reference products. In addition, IQVIA data found continued price erosion in competitive biologic classes as new biosimilars enter the market.

In efforts to capture rapid changes in the biosimilar market, researchers of this year’s Cardinal Health report drew on a nationwide survey of oncology and gastroenterology practices conducted in fall 2025, along with FDA approval data, market share and pricing trends. Additional sources included electronic medical records, group purchasing organization data and revenue cycle management insights to better understand clinical adoption, reimbursement challenges and operational pressures.

According to the report, regulatory shifts are expected to accelerate adoption. In October 2025, the FDA issued draft guidance proposing to streamline biosimilar approvals by waiving comparative efficacy studies for many products and eliminating switching studies for interchangeability designation. These changes reduce development costs and speed market entry, which could translate into lower prices for patients and payers.

Physician confidence in biosimilars also remains high. It was found that 99% of surveyed practices said they are at least somewhat confident explaining these therapies to patients. Stable reimbursement and robust clinical data were cited as the most important factors influencing adoption. Payer policies also play a role, with 53% of practices reporting that mandates or formulary management influence decisions to switch products.

In addition, the biosimilar pipeline continues to expand. More than 90 biosimilars have received FDA approval to date, and nearly 25 additional products are expected within the next two years. High-cost oncology biologics are among those facing new competition, including Yervoy (ipilimumab), Perjeta (pertuzumab), Keytruda (pembrolizumab) and Opdivo (nivolumab).

Oncology biosimilars have also shown rapid uptake, achieving an average market share of 81% within five years of launch. Price competition has been significant, particularly with trastuzumab biosimilars which saw a 76% drop in average sales price within three years.

Based on the findings, research suggests that the biosimilar market is maturing quickly.

According to Craig Cowman, president of Biopharma Solutions and Strategic Sourcing at Cardinal Health, “Biosimilars are projected to continue delivering billions of dollars in savings to the healthcare industry.”

This growth could happen because regulatory changes are expected to speed approvals, the biosimilar pipeline is strong and doctors feel confident using these products. However, how biosimilars are reimbursed remains a major issue. Practices expressed in the report they want predictable payments and clear discount rules to reduce financial uncertainty and support long-term use.