Cigna’s head of pharmaceutical benefits, Express Scripts, said on Monday it would put “several” biosimilar versions of Abbvie Humira’s pricey rheumatoid arthritis drug in the “same position as the brand” on the PBM formulary in 2023. .
Humira, approved by the US Food and Drug Administration 20 years ago, has for years been one of the country’s costliest drugs, generating more than $20 billion in sales for its maker, Abbvie in 2021. only. Cigna and Express Scripts said Humira, which treats inflammatory and skin conditions, is one of the most widely used specialty drugs.
Cigna Pharmacy and Express Scripts will join UnitedHealth Group’s OptumRx next year, creating competition for cheaper biosimilars and bringing potential savings to the US healthcare system. Because Humira is so expensive at more than $50,000 per year per patient, Cigna’s decision means that thousands of patients could potentially be moved in 2023 to cheaper alternatives and save Cigna and Express Scripts customers and the US healthcare system potentially worth billions of dollars a year.
“This decision helps us reduce costs for patients and plans while providing patients and providers with choice and flexibility as new biosimilars come to market,” said Harold Carter, Head of Pharmaceutical Commercial Relations. at Express Scripts. “The lack of competition allows exorbitant prices for prescription drugs. We can generate more competition in the inflammatory drug class by adding biosimilars to our larger formularies in the coming months and do what we do best: reduce drug costs for the millions of people we serve.
There have already been a growing number of studies showing that biosimilar versions of Humira are just as effective and safe as Humira. So doctors and PBM executives see no reason why patients can’t choose the cheapest biosimilar versions.
“By adding biosimilars to preferred status in the coming months, we can provide options in this complex and dynamic market,” Carter said.
Data from Express Scripts shows that specialty drugs “generate half of total drug spending, despite being used by less than 2% of the population.”
“As always, we will remain nimble and continue to negotiate with drugmakers to help patients and plans lower their drug costs,” Carter said. “It takes market competition to drive down drug prices over the long term, and it requires close coordination of care to help patients start a new drug. We are uniquely positioned to do both and, in doing so, support access to these safe and effective medicines for those we serve.
Humira, which treats autoimmune diseases including Crohn’s disease and rheumatoid arthritis, has generated nearly $200 billion in sales for its manufacturers over the past two decades.
Neither Abbvie nor its former parent company, Abbott Laboratories, discovered Humira. Abbott, then CEO of Miles White, discovered Humira through acquisition, a 2001 purchase of Knoll Pharmaceuticals for nearly $7 billion in cash. Abbott spun off its branded drug business in 2013 into what became Abbvie.
When Abbott purchased Humira, the biologic was already in the late stages of development and the latest clinical trials were giving the product a promising look. Knoll also brought Abbott several top-selling drugs, including the popular Synthroid thyroid treatment and other brand name prescriptions that have generated billions of dollars in sales over the years, making the acquisition of Humira less financially risky.
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