Budget Impact Analysis Finds Cost Savings When Switching to Humira Biosimilars
According to a study, increased competition brought about by the emergence of biosimilars in the market has resulted in a CAGR decrease of 5% to 20% in biosimilar and reference product pricing. It is estimated that biosimilars have saved payers, and in the end patients, more than $100 billion over five years.
Humira (adalimumab) is a tumor necrosis factor (TNF) inhibitor approved by the FDA to treat several autoimmune inflammatory conditions, including Crohn’s disease and ulcerative colitis. To date, ten adalimumab biosimilars have been approved in the U.S.
Biosimilars are considered very similar to their corresponding reference biologics, with similar associated risks and treatment benefits. According to a study published ahead of print in the September 2024 issue of the Journal of Managed Care and Specialty Pharmacy, increased competition brought about by the emergence of biosimilars in the market has resulted in a compound annual growth rate (CAGR) decrease of 5% to 20% in biosimilar and reference product pricing. It is estimated that biosimilars have saved payers, and in the end patients, more than $100 billion over five years.
Still, some studies have raised concerns that switching to biosimilars may increase health care resource utilization and costs by increasing the need for patient education on biosimilars and additional follow-up appointments.
To explore the potential financial impact of switching to biosimilar adalimumab, the study authors, led by Stephen Chaplin, B.Sc., from Cencora (formerly known as AmerisourceBergen), developed a 3-year budget impact model of a hypothetical U.S. commercial insurance plan of one million members. They evaluated the costs associated with several scenarios of adalimumab biosimilar use in patients with any of seven autoimmune disorders, including Crohn’s disease and ulcerative colitis.
The analysis included patients treated with reference adalimumab (Humira), any adalimumab biosimilar, and other self-injectable TNF inhibitors. The researchers explored three different scenarios pertaining to switching to biosimilar adalimumab. The first scenario was the conversion from Humira to other reference TNF inhibitors. The second scenario involved switching from Humira to biosimilar adalimumab. The third scenario evaluated the medical expenses associated with switching from Humira to biosimilar adalimumab.
The study results showed that with a target population of 1,863 patients, switching from Humira to biosimilar adalimumab resulted in an overall savings of $5,756,073 with a conversion rate of 10% to 20% over three years and $28,780,365 with a conversion rate of 50% to 100% over three years. The results were similar when switching from other self-injectable TNF inhibitors. Additional office visits for patient education or follow-up did not significantly affect the budget.
Chaplin and his colleagues conclude that in a model of one million people in a U.S. commercial plan, switching to biosimilar adalimumab can lead to significant cost savings for payers across several scenarios. These savings can trickle down to patient copays and cost-sharing prices.
This study was sponsored by Sandoz Inc. which makes Humira biosimilar Hyrimoz (adalimumab-adaz).
