Cigna Moves Remicade Biosimilars to Preferred Formulary Status

Beginning in July, Cigna is moving two Remicade (infliximab) biosimilars, Avsola and Inflectra, to preferred status on formulary. The company is offering patients a one-time $500 debit card for health care services and products if they switch to either biosimilar.

Cigna Chief Clinical Officer Steve Miller said the goal is to reduce current spending on Remicade, which he said costs $30,000 yearly on average, but spending on an individual can vary, depending on that patient's needs, the indication and site of care.

Remicade is a tumor necrosis factor blocker that is approved to treat patients with Crohn’s disease, ulcerative colitis, and psoriatic arthritis.

The FDA has approved four biosimilars for Remicade, with the most recent being Avsola (infliximab-axxq), which was approved December 2019. Others include Inflectra (infliximab-dyyb), approved April 2016; Renflexis (infliximab-abda), approved May 2017; and Ixifi (infliximab-qbtx), approved December 2017.

According to a 2020 report from Amgen, biosimilars in general have launched with a wholesale acquisition cost (WAC) that is 15% to 37% less than the originator, and Avsola launched with a WAC that was 57% lower than Remicade.

An Evernorth analysis from 2020 estimates that this biosimilar competition can save the United States $225 billion to $375 billion in pharmacy spend by the year 2031. (Express Scripts in now part of the Evernorth brand.)

“The shared savings program serves as a down payment on the future promise of biosimilars. At a time when many people are having to make difficult decisions related to how to afford their medications, this program will offer some direct financial relief and position customers and their employers to recognize greater long-term cost savings,” Miller said.