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The Benefits of Biosimilars

Wednesday, November 9, 2022

The U.S. Food and Drug Administration (FDA) began approving biosimilars in 2015. Biosimilars are biologic drugs or products generally made from living organisms, such as yeast and bacteria that are similar to other FDA-approved biologic drugs (referred to as reference drugs or reference products). A biosimilar does not differ from a reference drug in a clinically meaningful way in terms of safety, purity or effectiveness. There are now 38 FDA-approved biosimilars available to treat various diseases that include but are not limited to certain cancers and kidney and autoimmune diseases.

Interchangeable Biosimilars

Where state laws allow, some biosimilars – referred to as interchangeable biosimilars – meet additional requirements that allow them to be substituted without requiring a prescribing provider’s approval. This is similar to substituting a generic drug in place of a more expensive brand name drug. Biosimilars and interchangeable biosimilar drugs/products, which have similar effectiveness as reference drugs/products, save patients money. Lower costs allow increased access to life-saving treatments.

TRICARE Drug and Vaccine Coverage

TRICARE covers most FDA-approved prescription drugs (including biosimilars) and FDA-approved age-appropriate vaccines (including biosimilars) that follow the U.S. Centers for Disease Control and Prevention’s (CDC) vaccine guidelines. Let your TRICARE patients know they can learn more about prescription drug coverage at www.tricare.mil/drugs and vaccine coverage at www.tricare.mil/immunizations.

As a reminder for your TRICARE patients, vaccines do not have any costs when received at:

  • Military hospitals or clinics.
  • Network pharmacies.
  • TRICARE-authorized providers (office visit copayment may apply if other services are rendered).

For more information on biosimilars, visit the FDA’s website at www.fda.gov/biosimilars. For more information on pharmacy benefits, visit our Pharmacy page.