Over a decade since their introduction, biosimilars were once hailed as a key to lowering the cost of cancer treatment while maintaining high clinical standards. But in 2025, the question remains: Is this market thriving—or just barely surviving?

At a recent AVBCC panel led by Dr. Barry Brooks, a founder of Texas Oncology, stakeholders from across the healthcare landscape gathered to discuss whether biosimilars are still on the path to market sustainability—or in danger of vanishing altogether.

What Are Biosimilars, and Why Do They Matter?

A biosimilar is a biologic product that is nearly identical in safety, potency, and effectiveness to an already FDA-approved biologic, often referred to as the reference product or “innovator.”

For example, Texas Oncology transitioned from Neupogen (reference) to Zarxio (biosimilar) within three months—highlighting the potential for rapid adoption. According to Dr. Brooks, the name “biosimilar” is misleading:

“They’re not biosimilar. They’re biosame.”

Despite the clinical equivalency and cost benefits, adoption has lagged behind expectations in the U.S.

What’s Holding Biosimilars Back?

1. It’s Not a Provider or Patient Problem

Panelist Sean McGowan of AmerisourceBergen emphasized that prescribers and patients aren’t the issue. Instead, the bottleneck lies within market access restrictions and payers:

“If we can get managed care organizations to stop restricting access and allow providers and patients to decide, we’d see more sustainability.”

2. Lack of Manufacturer Competition

Another major hurdle is the limited number of biosimilar manufacturers entering the space. High development costs, low profit margins, and unpredictable reimbursement models discourage participation.

3. Price Wars and Market Instability

As biosimilar manufacturers slash prices to gain market share, many lose profitability and withdraw from the market, hoping to reset pricing later. This cycle of entry and exit contributes to instability and erodes provider confidence.

What Needs to Change?

A Call for Policy Reform

Dominick Oliverio of Pfizer stressed that sustainable growth requires federal and private payers—especially CMS—to rethink how biosimilars are reimbursed and supported.

“It’s time to take all those lessons learned from the first decade and adjust the rules of the game.”

Pfizer and others are now actively engaging with CMS to push for policy changes that protect biosimilar value and incentivize long-term participation.

A Quiet Success—But for How Long?

Even with these setbacks, biosimilars have delivered real economic impact. Oliverio described the market as a “tremendously successful experiment” that has:

  • Saved billions in healthcare costs
  • Created room in budgets for new cancer innovations
  • Demonstrated equivalent patient outcomes to reference biologics

However, success isn’t guaranteed. Without better structural support, the very companies that brought cost-saving therapies to market may start walking away.

Conclusion: A Turning Point for Biosimilars

The U.S. biosimilar market sits at a crossroads. The first decade showed promise; the next must deliver sustainability. It’s time for stakeholders—manufacturers, providers, payers, and policymakers—to work together and rebuild trust, reward innovation, and protect patient access.

Because in this high-stakes market, it’s not just about cost or competition—it’s about whether biosimilars survive or become extinct.