Express Scripts to Remove Humira from Commercial Formularies
Beginning in 2025, Express Scripts will favor biosimilars of Humira, including its own private-label version.
Beginning in 2025, Express Scripts will remove Humira (adalimumab) from its commercial formularies, favoring instead several biosimilars. Biosimilars that will be available include
- Cyltezo (adalimumab-adbm) and its unbranded version (Boehringer Ingelheim) in both high- and low-concentration formulations
- Simlandi (adalimumab-ryvk) (Teva), the first interchangeable biosimilar with Humira, high concentration, 40mg strength
- Adalimumab-adaz (Sandoz), unbranded high-concentration formulation, with interchangeable 10mg, 20mg, and 80mg strengths and noninterchangeable 40mg strength
- High- and low-concentration interchangeable biosimilar products produced for Quallent Pharmaceuticals through agreements with multiple manufacturers.
Adam Kautzner
“We’ve been thoughtful in developing a comprehensive approach that considers not just the formulary placement of biosimilars, but also each product’s clinical efficacy, interchangeability, available supply, dose, and concentration that will provide a seamless patient experience with these more affordable products,” Adam Kautzner, president of Evernorth Care Management and Express Scripts, said in a news release.
Humira and the biosimilars are used to treat several immune conditions, including rheumatoid arthritis, juvenile idiopathic arthritis, psoriatic arthritis, ankylosing spondylitis, psoriasis, ulcerative colitis, Crohn’s disease, uveitis, and hidradenitis suppurative. Humira has a price of $7,299 according to Drugs.com. Express Scripts has included preferred biosimilars on its largest commercial formularies alongside Humira since February 2023.
Earlier this year, both Boehringer Ingelheim and Quallent entered into agreements to provide Express Scripts with private-label options of the Humira biosimilars.
Express Scripts began offering the biosimilars from Quallent in June 2024 for $0 out of pocket for eligible patients of the specialty pharmacy Accredo. This is estimated to save individual patients around $3,500 on average per year, according to Express Scripts. The biosimilar is about 85% lower than the list price for Humira.
Express Scripts isn’t the only PBM to remove Humira from its formularies. Effective April 2024, CVS Caremark removed Humira from its national commercial template formularies in favor of biosimilars.
CVS launched Cordavis in August 2023, which is working directly with pharmaceutical manufacturers to co-produce biosimilar products. CVS Caremark has announced that AbbVie, the manufacturer of Humira, has entered into an agreement to supply Cordavis with a committed volume of co-branded Humira. Cordavis has also contracted with Sandoz to commercialize and bring to market Hyrimoz, another Humira biosimilar produced by Sandoz, under a Cordavis private label.
Earlier this month in an investor call, Karen S. Lynch, CVS Health president and CEO, that Cordavis line of private label biosimilars has begun to show savings for clients.
