In case of biosimilar, the price cuts have not been more than 10-20%, which basically is not an incentive enough for the insurers in the market to push their payers down this route (And as cases of Humira and Remicade are proof, the original biologic player themselves shave off the price...
(e.g., metronidazole) AND There is documentation in the medical record that the patient had an inadequate response, intolerance, or contraindication to ONE of the following medications: Humira (adalimumab), Cimzia (certilizumab pegol), Remicade (infliximab), Entyvio (vedolizumab), ...