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Physician-Level Cost Control Measures and Regional Variation of Biosimilar Utilization in Germany

1
CINCH—Health Economics Research Center, Faculty of Economics and Business Administration, University of Duisburg-Essen, 45127 Essen, Germany
2
Leibniz Science Campus Ruhr, 45030 Essen, Germany
*
Author to whom correspondence should be addressed.
Current address: Verband der Ersatzkassen e.V. (vdek), 10963 Berlin, Germany.
Int. J. Environ. Res. Public Health 2020, 17(11), 4113; https://doi.org/10.3390/ijerph17114113
Received: 8 May 2020 / Revised: 1 June 2020 / Accepted: 2 June 2020 / Published: 9 June 2020
(This article belongs to the Special Issue Biosimilars: Economic, Health Policy, and Public Health Issues)
Biologic drugs represent a large and growing portion of health expenditures. Increasing the use of biosimilars is a promising option for controlling spending growth in pharmaceutical care. Amid the considerable uncertainty concerning physicians’ decision to prescribe biosimilars, explicit cost control measures may help increase biosimilar use. We analyze the role of regional cost control measures for biosimilars and their association with physician prescriptions in ambulatory care in Germany. We collect data on cost control measures implemented by German physician associations and national claims data on statutory health insurance covering 2009 to 2015. We perform panel regressions that include time and physician fixed effects to identify the average associations between cost control measures and biosimilar share/use while controlling for unobserved physician heterogeneity, patient structure, and socioeconomic factors. We identify 44 measures (priority prescribing, biosimilar quota) for erythropoiesis-stimulating substances, filgrastim, and somatropin. Estimates of cost control measures and their consequences for biosimilar share and use are heterogeneous by drug, measure type, and physician group. Across specialists, biosimilar quotas accounted for 5.13% to 9.75% of the total average biosimilar share of erythropoiesis-stimulating substances. Explicit quota regulations are more effective than priority prescribing. Regional variation in biosimilar use can be partly attributed to the presence of cost control measures. View Full-Text
Keywords: biologic; biopharmaceutical; cost control; panel regression; administrative data biologic; biopharmaceutical; cost control; panel regression; administrative data
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MDPI and ACS Style

Blankart, K.E.; Arndt, F. Physician-Level Cost Control Measures and Regional Variation of Biosimilar Utilization in Germany. Int. J. Environ. Res. Public Health 2020, 17, 4113. https://doi.org/10.3390/ijerph17114113

AMA Style

Blankart KE, Arndt F. Physician-Level Cost Control Measures and Regional Variation of Biosimilar Utilization in Germany. International Journal of Environmental Research and Public Health. 2020; 17(11):4113. https://doi.org/10.3390/ijerph17114113

Chicago/Turabian Style

Blankart, Katharina E., and Friederike Arndt. 2020. "Physician-Level Cost Control Measures and Regional Variation of Biosimilar Utilization in Germany" International Journal of Environmental Research and Public Health 17, no. 11: 4113. https://doi.org/10.3390/ijerph17114113

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