Pfenex Statement on Announcement by CMS to Establish Separate J-Codes for Biosimilars

Pfenex is supportive of the decision by the Centers for Medicare and Medicaid Services (CMS) to adjust the current Part B reimbursement code model, moving instead to a system that assigns each biosimilar a unique Healthcare Common Procedure Coding System (HCPCS) code, or “J-code.” This move, which allows payment for biosimilars using the Average Sales Price (ASP) or each biosimilar, stands to increase competition and innovation by spurring biosimilars uptake.

This decision demonstrates CMS’ support for biosimilar access and sustainability in the U.S., ensuring an equal playing field for biosimilars compared to an innovator product and encouraging a competitive market for patients.