Humira Biosimilars Got Off to a Slow Start. Has That Changed? | AMCP Nexus 2024

Although there are now 10 biosimilars to Humira (adalimumab) on the market, they are struggling to compete against their brand-name reference product, the top-selling drug of all time, according to panelists at session today on increasing adoption of Humira biosimilars at the 2024 Academy of Managed Care Pharmacy Nexus in Las Vegas.

Jason Bioc, Pharm.D.

“Penetration is very low compared to the number of products that we have on the market,” said Justin Bioc, Pharm.D., head of clinical pharmacy at Devoted Health, a health insurance startup.

Bioc said the contrast to the generics to small-molecule drugs is stark. “If you just think about generic drugs, once generics come out, and there are a few generics on the market, they generally take over in terms of utilization across your prescription volume, [but this] hasn't been the case with biosimilars.

Amgen’s Amjevita (adalimumab-atto), launched in Janaury 2023, was the first Humira to come on the market. It was joined by eight others in 2023 and another, Simlandi (adalimumab-ryvk), in May 2024.

Sophia Humphreys, Pharm.D.,M.H.A.

Another panelist, Sophia Humphreys, Pharm.D., M.H.A., director of formulary management and pharmacy clinical program for Sutter Health, said some biosimilars were covered by payers in 2023 but not a high percentage. She noted that said many Humira biosimilar manufacturers used a dual pricing strategy, which meant the same biosimilar had a high wholesale acquisition cost (WAC) price to satisfy payers and maintain rebates, but also another low WAC price that was on average 81% lower than Humira’s price. Even so, at the end of 2023, there was only 3% adoption of biosimilars, she said

In 2024, there is a different take on how to get biosimilars into the market, driven by PBM partnership strategies with the manufacturers, according to Bioc. Still, challenges to biosimilars remain, he said, includingPBM rebates and preferred products, payer coverage, formulary tiers and the risk of shortages.

Large PBMs have started taking Humira off some their formularies and replacing it with biosimilars, starting with CVS Caremark earlier this year. Optum Rx and Express Scripts followed suit. Last week, Prime Therapeutics announced that it will begin offering four Humira biosimilars as option to its Blue Cross clients. Humira biosimilar prescription have started to increase, and industry observers see the formulary changes as boosting them further, although there are still questions about the savings because of steps the PBMs have taken to protect their business interests.

Humphreys said education, as well as cost, is important to the adoption of biosimilars. She also mentioned transparency into PBM pricing and other policies that would be required under several pieces of legislation under consideration by Congress

“We're watching those policy changes very closely to monitor them and hopefully to bring more information and more update to our audience,” she said,

Bioc said that he feels the patient is often not considered due to policies that designed to meet the business needs for payers, providers, PBMs and manufactures. Right now, the net price of biosimilars are changing, but patients have been experiencing really high prices. Education, he adds, is the key to aligning incentives of all parties involved. He stated that sometimes “we do not understand the other players.”

“At the end of the day, we all have something to gain here with biosimilars and looking at the [Humira] market in particular, time is money,” Bioc said. “It’s money for everyone, for patients, for payers, for providers and IDNs [integrated delivery networks] and pharmacies, it's not something that we can continue to wait on.”