In-sewer transformation of drug biomarkers (excreted parent drugs and metabolites) can be influenced by the presence of biomass in suspended form as well as attached to sewer walls (biofilms). Biofilms are likely the most abundant and biologically active biomass fraction in sewers. In this study, 16 drug biomarkers were selected, including the major human metabolites of mephedrone, methadone, cocaine, heroin, codeine and tetrahydrocannabinol (THC). Transformation and sorption of these substances were assessed in targeted batch experiments using laboratory-scale biofilm reactors operated under aerobic and anaerobic conditions. A one-dimensional model was developed to simulate diffusive transport, abiotic and biotic transformation and partitioning of drug biomarkers. Model calibration to experimental results allowed estimating transformation rate constants in sewer biofilms, which were compared to those obtained using in-sewer suspended biomass. Our results suggest that sewer biofilms can enhance the transformation of most compounds. Through scenario simulations, we demonstrated that the estimation of transformation rate constants in biofilm can be significantly biased if the boundary layer thickness is not accurately estimated. This study complements our previous investigation on the transformation and sorption of drug biomarkers in the presence of only suspended biomass in untreated sewage. A better understanding of the role of sewer biofilms-also relative to the in-sewer suspended solids-and improved prediction of associated fate processes can lead to more accurate estimation of daily drug consumption in urban areas in wastewater-based epidemiological assessments.