Biosimilars: Your Business’ Alternative in Healthcare Spending
July 28, 2025 | Tags:
Did you know prescription drug costs are projected to rise nearly 8% this year? For employers, that’s not just a number; it’s a large part of their budget. But there’s a smarter way forward: biosimilars.
Biosimilars offer the same clinical outcomes as brand-name biologics, but at a fraction of the cost. No matter the size of your business, biosimilars can be a benefit to prescription health and your bottom line.
What are biosimilars—and why should employers care?
To understand biosimilars, let’s first take a look at biologics. Biologics are prescription drugs created from living cells. Unlike traditional medications which are chemically made and relatively simple, biologics are structurally complex molecules created using advanced technology.
Due to their intricate structure and how they’re made, biologics can’t be exactly replicated like generic medications. They’re also costly and time consuming to develop. That's where biosimilars come in. Biosimilars are highly similar versions of biologics as they’re made from the same types of living cells. While they’re not exact copies, biosimilars undergo the same rigorous testing and approval process from the Food and Drug Administration (FDA) as biologics and share the same:
- Benefits and risks
- Dosage
- Strength
- Side effects
Biosimilars require less time and money to develop, creating an affordable and accessible option to medications for serious or chronic conditions that are costly to treat, such as:
- Skin conditions, like Psoriasis
- Rheumatoid arthritis
- Some cancers
-
Inflammatory bowel diseases, like Crohn’s and ulcerative colitis
| Biological | Biosimilar |
|---|---|
| New treatment made from complex molecules | Highly similar to FDA-approved biologic product |
| Made from a living source | Made from a living source |
| Expensive and timely to develop | Less expensive and faster to develop |
| Carefully monitored through manufacturing for consistent quality | Carefully monitored through manufacturing for consistent quality |
| Patentable | Non-patentable |
The cost-saving power of biosimilars
Budget, budget, budget – it's what employers are chanting now more than ever. Coverage for pricey medications for inflammatory conditions and cancer treatments account for a large portion of the increases compounded by the 4% hike in pharmaceutical prices expected in the coming year.
Incorporating biosimilars into benefit strategies can help mitigate these rising costs. For example, Medical Mutual achieved up to 85% conversion of Humira to the biosimilar with savings per prescription up to 70%.
At the same time, supply chain vulnerabilities, operational demands, staffing shortages and pharmacy deserts in rural areas are making access to prescription drugs more difficult, pushing more patients to mail-order options. To help offset these obstacles for employers, biosimilars are emerging as a timely and practical alternative, helping employers improve access to quality, affordable care.
Real-world results: how employers are saving
Biosimilars enable employers to better manage healthcare spending without compromising high standards of clinical care for their employees. Typically priced 10% to 50% less than brand-name biologics, their purpose as a cost-effective alternative doesn’t compromise safety or efficacy.
For example, Medical Mutual has helped employers achieve significant savings through biosimilars – an average of almost $15 per employee per month (PEPM) – while maintaining quality standards of care and access. Those employers can then reinvest the savings made from biosimilars into other coverage areas, like wellness programs and added benefits, like dental, vision or life and disability.
Beyond lowering costs, biosimilars broaden the range of treatment options for patients, reducing access barriers and improving adherence to treatment plans. This can lead to better health outcomes. As a result, employees benefiting from affordable and effective treatment options contribute to higher employee satisfaction, improved retention and stronger company loyalty.
Medical Mutual’s biosimilar-first strategy
Medical Mutual is dedicated to supporting employers in making their group health plans simpler, more affordable and effective with biosimilars. Our team of over 90 pharmacy experts offer a personalized, hands-on approach to support biosimilar integration, working directly with providers and members to highlight biosimilar:
- Safety
- Effectiveness
- Cost saving potential
We've adopted a biosimilar-first strategy, carefully selecting formulary products that are widely available and offer the lowest net cost. As access to drugs like Humira and Stelara are affected by market changes, our team works closely with our pharmacy benefits manager, utilizing data and analytics to personally identify and transition members to biosimilar alternatives that best meet their needs medically and financially.
Medical Mutual goes beyond standard pharmacy benefit manager solutions to manage high-cost medications like biologicals by looking at the complete health of our members. Our custom designed clinical programs have proven savings, with a recent study showing that our utilization management program achieved over 16% (or $3.50 PMPM) more savings compared to similar self-funded peer groups in 2024.
Take action: how to start saving
Talk to your broker or call a Medical Mutual Sales representative to explore how a biosimilar-first strategy can benefit your business. You can also request a group quote to get started today or visit our website to learn more.