MedImpact Selects Simlandi and an Unbranded Humira Biosimilar

MedImpact Healthcare Systems is providing access to two Humira biosimilars: Alvotech/Teva's Simlandi (adalimumab-ryvk) and Sandoz’s unbranded adalimumab-adaz. Beginning in January 2025, patients new to medication for inflammatory conditions such as Crohn’s disease or rheumatoid arthritis will be required to step through these two biosimilars before trying Humira.

Arpit Patel, Pharm.D.

“We believe that this is a great opportunity to lower cost,” Arpit Patel, Pharm.D., vice president, trade relations at MedImpact said in an interview. “We’ve made two options available, both low list price, and we’ve made them available to any pharmacy that has the ability to source for them.”

MedImpact, however, is not requiring patients currently taking Humira to switch, and all three products are on a preferred tier. Member copay, deductible, and other factors will be the same for the biosimilars and Humira. Teva offers a $0 copay for Simlandi for those with commercial insurance.

Patel pointed that about 80% of patients receiving Humira are using a high concentration formulation, which allows the medication to be delivered faster.

“We’ve done research and outreach with physicians on their prescribing preferences,” Patel said. “Generally speaking, 60% to 70% of patients taking Humira are already stabilized. We recognize that and are leaving switching to a physician’s discretion. There is a significant amount of anxiety around inflammatory condition, which are chronic conditions. These are complex products. We had to consider physician’s willingness to switch.”

Both Simlandi and adalimumab-adaz are offered as low wholesale acquisition products with minimal rebates.

“The list prices on these products are significantly lower than Humira net-to-rebates,” Patel said. “We wanted to make sure that it’s a lower cost to the payer even with the net rebate. Most importantly, the member cost share is based on the list price, and we wanted to make sure that the member was able to get the advantage associated with these lower list prices.”

Patel said MedImpact based its decision on several factors. The first was the clinical profile. They wanted to make sure the biosimilars they selected were high-concentration, interchangeable products that could be self-administered. “The pricing also had to make sense with the lowest net cost,” he said.

Additionally, they were looking for manufacturers that had the right infrastructure to support patients, with coupons and toll-free numbers to address patient questions and concerns. “We didn't want any challenges with member access to the product, meaning it had to be available across the supply chain and across pharmacies. We didn’t want to lock any member into a particular location or requiring a specific pharmacy,” Patel said.

He said as new biosimilars become available for Humira and other biologics, they will use a similar strategy to assess option for their members. Next year, biosimilars are expected to become available for Janssen Biotech’s Stelara (ustekinumab). So far, the FDA has approved three Stelara biosimilars: Samsung Bioepis’ Pyzchiva; Alvotech and Teva Pharmaceuticals’ Selarsdi and Amgen’s Wezlana.

At least four other Stelara biosimilars are under FDA review, including Accord BioPharma’s DMB-3115, Biocon’s BMAB-1200, Celltrion’s CT-P43, and Fresenius Kabi and Formycon’s FYB202. CT-P43 was just approved by the European Commission as SteQeym, and FYB202 has received a positive opinion by the Committee for Medicinal Products for Human Use of the European Medicines Agency