Understanding the U.S. Market Access Landscape for Biosimilars

Sponsored by: Covance

Focused on:

  • Biosimilars
  • Market Access
  • Payers
  • Reimbursement

Date: 12 May


Time: 1PM New York / 10AM Los Angeles

Considerations Related to Reimbursement and Customer Support

A key question to the successful uptake of biosimilars in the U.S. is how health insurers will control access to these products. In 2016, the reimbursement environment for these products is complex and uncertain. CMS’s recently finalized coding and payment policies have the potential to dramatically alter the market access landscape for biosimilars, and questions still remain regarding how these products will be reimbursed by commercial payers.

To better understand the commercial payer perspective on biosimilars, Covance Market Access Services surveyed its panel of managed care decisionmakers, with survey respondents representing over 100 million covered lives. The survey was designed to explore several factors that may influence how commercial payers manage biosimilars, including therapeutic area, interchangeability, and pricing.

In this webinar, Covance subject matter experts will present key findings from the payer survey and discuss their implications for market access for biosimilars. We also will review CMS’s controversial policies on biosimilar coding and payment, and will discuss the importance of offering robust customer support resources -- such as full-service reimbursement hubs and patient assistance programs -- to facilitate market access for these products.

If your company is developing or commercializing biosimilar therapies, or if biosimilar alternatives pose a competitive threat to your established portfolio, then you need to understand the market access landscape for these products. If you are seeking to learn more about this topic, please register for this webinar.

Presented by

John Carlsen,

Vice President, Consulting

John Carlsen has more than 15 years of experience with coding, coverage, and reimbursement issues in various settings of care. Mr. Carlsen specializes in assessing the impact of changes to Medicare and managed care payment systems on the reimbursement of drugs, biologics, and devices, and has collaborated with manufacturers on market access strategy projects in a variety of therapeutic areas. He closely follows the latest health care policy developments and, most recently, has worked with numerous clients in the areas of biosimilars, Medicare drug payment policy, health care reform, ACOs and bundled payments, the 340B drug pricing program, off-label coverage and compendia, and ICD-10 implementation.

Prior to joining Covance, Mr. Carlsen worked at the Ohio State University (OSU) Medical Center in Columbus, Ohio, where he focused on financial management and medical information management issues.

Mr. Carlsen received an M.H.A. from OSU's Graduate Program in Health Services Management and Policy, and a B.A. in Economics with minors in Business and Psychology from Duke University.

Kristi Skorija,

Director, Consulting

Kristi Skorija specializes in U.S. market access and reimbursement for biotech, pharmaceutical, diagnostic, and medical device technologies, with a focus on coding, coverage, and reimbursement policies for these products. She has experience across a broad range of therapeutic areas, including nephrology, wound care, oncology, hematology, cardiology, and infectious disease. Ms. Skorija has extensive experience conducting in-depth qualitative interviews with key reimbursement decision makers and clinical experts across various settings of care.

Prior to joining Covance, Ms. Skorija worked in a laboratory research setting in the endocrine unit at Massachusetts General Hospital and at CVPath conducting cardiovascular pathology assessments for medical devices and other cardiovascular therapies. Ms. Skorija received an M.B.A. from the MIT Sloan School of Management. During her time at Sloan, she focused on healthcare management and data analysis, with special interest in strategy and market analysis.

Key Learning Objectives

  • Review key CMS policy developments for biosimilars (e.g., Medicare guidance, coding decisions, payment policies) and understand the potential impact on commercial payers' policies
  • Highlight coding and Medicare payment for currently available biosimilar products, understand the link between coding/payment and pricing, and discuss what this means for biosimilars approved in the future
  • Gain insight into how commercial payers are covering and managing biosimilars, as well as the resulting impact on patient access to competing innovator products (based on original research conducted by Covance)
  • Assess the implications for reimbursement hubs, patient assistance programs, and other customer support resources


  • Health Economics Manager
  • Market Access Manager
  • Reimbursement Manager
  • Product Manager
  • Brand Manager
  • Business Development Manager
  • Marketing Manager
  • Strategic Planning Manager