6 August 2021 - France has a single payer health insurance system that has the authority to impose pharmaceutical price reductions but relies on decentralised market negotiations between hospitals and manufacturers to establish prices for injected and infused biologics. 

Hospitals rely on biosimilars—less expensive but therapeutically equivalent variants of biologic medications—to stimulate competition. Price reductions negotiated by hospitals subsequently are adopted by the health insurance system, driving hospitals to negotiate a new round of discounts. 

This article measures 2004–20 trends in prices, price reductions, utilisation, and market shares for three prominent biologics—Remicade, Enbrel, and Humira—and their eleven competing biosimilars.

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