Developments in the generic marketplace have an outsized impact on the hospital pharmacy budget. Just as shortages and outsourcer availability issues can lead to unexpected budget spikes, products moving off patent can introduce new opportunities for savings. The promise of savings from the burgeoning biosimilar marketplace remains tantalizing, although drastic price drops have yet to materialize. Most pharmacy departments have introduced biosimilars onto formulary and more are expected to follow. Pharmacy directors have become increasingly comfortable with biosimilar products; this year, for the first time, price outstripped clinical data as the main consideration for including biosimilar products on formulary.