Access read A biosimilar priced above the brand it copies looks like a market failing. It is closer to the formula working exactly as written. Physician-administered drugs in the United States are reimbursed at average sales price plus a percentage, which means the practice buying and administering the drug earns more, in absolute dollars, from a more expensive product. At roughly $300 the margin on a Byooviz injection was negligible; at $1,190 it is not. The commercial history follows that arithmetic precisely. Biogen launched this product, could not make it work, and handed the rights back. A new partner has relaunched it at close to four times the price, and the reason to expect better this time is not that the medicine changed. What this exposes is a reimbursement design that rewards expense at the point of administration, and the consequence is a biosimilar repricing upward to become sellable, which is the reverse of the entire policy rationale for having biosimilars at all. Read it alongside the other two retina stories of the past week, an FDA-approved ophthalmic bevacizumab entering a market where the compounded version already dominates on price, and a Roche implant approved in Europe on convenience rather than efficacy. Retina is where the uncoupling of price from value is easiest to see, because the drugs have barely changed in twenty years and almost everything else has.