Despite FDA approval of 84 biosimilars with 67 available to patients, adoption remains uneven with average market shares around 40%. The Biosimilars Council highlights barriers including pharmacy benefit managers favoring pricier brand-name drugs and a thin development pipeline—only 12 biosimilars are in development out of 118 biologics losing exclusivity by 2034. These factors threaten future savings and competition, sustaining high brand-name drug prices across therapeutic areas.