Biologic drugs are some of the most expensive medicines on the market. They treat serious conditions like rheumatoid arthritis, Crohn’s disease, cancer, and psoriasis. But here’s the catch: brand biologics can cost over $80,000 a year per patient. Meanwhile, their cheaper alternatives-called biosimilars-are often priced more than half off. So why aren’t more people using them?
What’s the real price difference?
In the first half of 2025, the average 30-day prescription for a brand biologic in the U.S. cost $2,104. The same treatment, if taken as a biosimilar, cost just $919. That’s a 56% drop in price. For patients paying out-of-pocket, that means saving nearly $1,200 every month. Over a year, that’s more than $14,000 saved. Take Humira, for example. Before biosimilars hit the market, it was the most expensive drug in the U.S., with a list price of about $80,000 per patient annually. After biosimilars entered in 2023, the original drug’s price dropped 25% on its own-just because of competition. Meanwhile, biosimilars like Hyrimoz launched at 80% off the original price. Today, biosimilars make up 65% of the adalimumab market. That’s not just a discount-it’s a market shift.Why are biosimilars cheaper?
Unlike regular generic pills, which are exact copies of small-molecule drugs, biosimilars aren’t identical to their brand-name counterparts. Biologics are made from living cells-think yeast, bacteria, or animal cells-so they’re complex, messy molecules. You can’t just mix chemicals in a lab and get the same thing. That’s why biosimilars take years and hundreds of millions of dollars to develop. But here’s the key: they don’t need to be identical. The FDA only requires them to be highly similar in structure, function, and safety. That means biosimilar makers can skip expensive, lengthy clinical trials. They don’t have to prove the drug works from scratch. They just need to show it behaves the same way in the body. That cuts development costs dramatically. So while a traditional generic pill might cost 90% less than the brand, biosimilars typically launch at 40-50% off. And unlike generics, which often drop even further after multiple competitors enter, biosimilars tend to stay at that 50% discount level for years. That’s still massive savings.Who’s saving money-and who’s not?
Since 2015, biosimilars have saved the U.S. healthcare system between $36 billion and $56 billion, depending on who’s counting. In 2024 alone, they saved $12-20 billion. That’s billions of dollars that didn’t go to drug companies, insurers, or patients. But here’s the problem: those savings aren’t always reaching the people who need them. Pharmacy Benefit Managers (PBMs)-the middlemen who negotiate drug prices for insurance plans-often push for the most expensive brand biologics because they get bigger rebates from drugmakers. It’s called a “rebate wall.” Even if a biosimilar is cheaper, the PBM might still steer patients toward the brand because the rebate check is bigger. Doctors, too, sometimes default to the brand. Many weren’t trained on biosimilars. Some are worried about liability. Others are just used to prescribing what they’ve always prescribed. And patients? They’re often told, “This is the one your doctor recommends,” without knowing there’s a cheaper option that works just as well.
Why aren’t there more biosimilars?
There are 76 biosimilars approved by the FDA as of October 2025. Sounds like a lot? It’s not. There are about 600 brand biologics on the market. Only about 10% of the biologics expected to lose patent protection in the next 10 years even have a biosimilar in development. Why? Because brand drugmakers use legal tricks to block competition. They file dozens of patents-sometimes on tiny, insignificant parts of the drug’s delivery system or manufacturing process. This creates what experts call a “patent thicket.” A biosimilar maker might spend $150 million to develop a drug, only to get sued on 20 different patents. The legal battle can delay market entry for years. The FDA knows this. In September 2025, they released new draft guidance to simplify the approval process. They want to reduce unnecessary clinical trials and speed up reviews. But until the legal and financial incentives change, the pace of biosimilar entry will stay slow.What’s the future look like?
The good news? Biosimilar use is growing. Analysts at Evaluate Pharma predict that by 2030, biosimilars will make up 35-40% of the biologic market-up from just 15-20% today. That could mean $125 billion in annual savings. The Biden administration’s new Biosimilars Action Plan aims to fix reimbursement rules, encourage prescriber education, and push insurers to favor biosimilars. States like California and New York are already requiring pharmacists to notify patients when a biosimilar is substituted. And the savings don’t stop at the pharmacy counter. When a drug like Humira drops from $80,000 to $16,000 a year, it means fewer patients skip doses because they can’t afford it. Fewer hospitalizations. Fewer emergency visits. That’s savings for the whole system.