Epoetin alfa: Epogen and 1 biosimilar

1 biosimilar bill against Epogen (J0885). On average they are paid ↑ 22.5% relative to the reference product per 1000 UNITS in 4Q26.

Epogen (reference)
Retacrit

Payment limit per 1000 UNITS, last 8 quarters. Reference product as the thick navy line, biosimilars in teal and other colors.

All products

Product	Code	CMS description	Per 1000 UNITS	vs. reference	CMS 8% add-on note	8 quarters
Epogen	J0885	Epoetin alfa, non-esrd	$6.669	Reference	–
Retacrit	Q5106	Inj retacrit non-esrd use	$8.171	↑ 22.5%	No

Payment limits are from the CMS 4Q26 file. Which products are grouped together comes from the site’s biosimilar groups list (reference/biosimilar_groups/2026-10-17T183707Z_d3109bb50c53.csv), checked by hand; it is not a CMS file. “CMS 8% add-on note” shows whether CMS’s notes say the 8% of reference product add-on was applied.

Medicare Part B usage

Epoetin alfa market in Medicare

$80.1M Medicare Part B spending, 2025 (preliminary)

309,009 claims in 2025 (preliminary); 12,542,326.6 billing units (1000 units each) in 2024

50.0% of 2025 claims were for biosimilars, vs. 47.3% in 2024

$17.4M spending so far in 2026 (Q1, preliminary)

Spending by product

Market share (share of claims)

Epogen (reference)
Retacrit

Medicare Part B fee-for-service spending and claims by calendar year. Years marked “prelim.” come from CMS’s quarterly spending file and will be replaced when CMS publishes the yearly file. Market share is each product’s percent of the group’s claims that year; claims are used because the quarterly file has no dosage units. A product with no bar for a year is not in CMS’s file for that year.

By product

Product	Spending 2024	Units 2024	Spending per unit 2024	Spending 2025 (prelim.)	Claims 2025	Share of claims 2025	Spending 2026 (Q1)
Epogen J0885	$54,084,732.81	6,725,572.6	$8.041654745	$40,461,464.56	154,613	50.0%	$8,748,759.21
Retacrit Q5106	$42,430,039.04	5,816,754	$7.294453064	$39,657,818.27	154,396	50.0%	$8,676,662.31

Spending, units and claims are CMS figures; spending per unit is CMS’s own average for 2024. Units are billing units, which can differ between codes, so compare units only between codes billed per the same amount. Shares are this site’s calculation from CMS claims. CMS may count spending differently in its quarterly and yearly files, so treat changes between 2024 and 2025 with care.

Physician-billed use by state, 2024

From CMS’s Physician & Other Practitioners by Geography and Service file, which covers drugs billed by physicians and other practitioners, mostly in offices. Drugs billed by hospital outpatient departments are not in it. For these products it covers 60.8% of 2024 Medicare units. CMS leaves out a state’s row for a product when fewer than 11 patients received it, so small states may undercount.

Hover over a state to see its figure. Territories and states with no data are in the table.

Show 50 states and territories

State	Services (billing units)	Biosimilar share
Florida	2,222,756	25.3%
California	934,832.5	38.4%
Texas	561,601	51.2%
New Jersey	524,731	43.4%
New York	407,683.6	35.3%
Arkansas	259,402	11.5%
Pennsylvania	251,950	35.7%
Maryland	230,102	50.1%
Illinois	217,312	34.8%
Virginia	212,959	19.6%
Arizona	157,683	22.5%
Georgia	141,588	12.4%
Ohio	138,648	39.2%
South Carolina	138,605	24.1%
Massachusetts	121,038	52.1%
North Carolina	119,122	61.5%
Michigan	98,688	30.5%
Connecticut	83,068	53.2%
Indiana	72,625	27.0%
Alabama	66,621	61.5%
Oregon	65,506	48.7%
Mississippi	44,040	54.1%
Utah	42,930	53.4%
Louisiana	41,994	30.8%
Washington	41,090	32.9%
Tennessee	39,522	36.1%
Kansas	35,668	57.2%
Nebraska	35,307	45.4%
Missouri	33,975	56.7%
Nevada	33,266	58.4%
Kentucky	32,090	38.1%
Delaware	30,094	100.0%
New Mexico	21,336	12.2%
New Hampshire	19,666	47.4%
Oklahoma	19,491	16.6%
Iowa	18,838	37.4%
Colorado	17,950	38.2%
Hawaii	15,508	34.7%
Wisconsin	15,490	43.4%
Minnesota	12,028	17.4%
Vermont	10,740	0.0%
Rhode Island	9,340	80.5%
Guam	6,510	100.0%
Puerto Rico	4,510	100.0%
Maine	2,320	0.0%
Idaho	2,000	100.0%
North Dakota	1,660	0.0%
Wyoming	1,430	100.0%
West Virginia	855	0.0%
District of Columbia	320	100.0%

Sources: 2026-06-25_DSD_PTB_RY26_P06_V10_DYT24_HCPCS-260602.csv, 2026-05-21_MUP_PHY_R26_P05_V10_D24_Geo.csv.gz, 2026-07-23_qddptb_r2603_p06_v10_dqt2601_260722.csv (data.cms.gov).