Top PBM to put Humira biosimilars on level playing field with AbbVie blockbuster

Paul Schloesser

Associate Editor

Humira is the best selling drug of all time. And as biosimilars for the drug venture onto the open market in Jan. 2023, one of the big three PBMs is making room for the biosimilars to compete on equal footing with the brand-name version.

UnitedHealth Group’s PBM OptumRx — one of the largest in the US along with CVS Health and Express Scripts —  signaled Tuesday that it will place three biosimilars for the AbbVie-made drug sales king on its formulary, its preferred list of drugs, at parity with Humira, allowing biosimilars to compete on the same tier as the drug itself.

Amgen is expected to launch the first biosimilar to compete with Humira early next year and will be the first added to the formulary.

Humira was first approved by the FDA in 2002 for rheumatoid arthritis, adding new indications over the years and rising to become the most profitable drug ever, hauling in between $15 billion and $20 billion in sales per year.

Beginning in January, with the entrance of Amgen’s biosimilar, AbbVie will have to fend off competition from Samsung, Boehringer Ingelheim, Viatris, and Sandoz, which are launching their versions of adalimumab next June and July.

AbbVie has signaled that it expects about 45% erosion (+/-10%) of its Humira franchise in 2023, after seeing sales similarly plummet in the EU when biosimilars launched there four years ago. AbbVie management also previously indicated that interchangeable biosimilars (a designation Boehringer’s biosimilar already has) will have some impact on pricing as two interchangeable biosimilars were baked into AbbVie’s guidance.

AbbVie preps for an onslaught of Humira biosimilars in 2023, with Skyrizi and Rinvoq to fill the gap for now. AbbVie did not respond to a request for comment from Endpoints News on the OptumRx move.

OptumRx will look to create even more competition for biosimilars, given Humira’s list price of $70,000 a year per patient, and studies showing biosimilars are as safe and effective as Humira — effectively an equivalent at a cheaper price. And given OptumRx’s clout as both one of the largest PBMs in the US and the subsidiary of health insurance provider UnitedHealthcare, others could follow.

During a session on Tuesday at the HLTH Conference in Las Vegas, OptumRx CEO Heather Cianfrocco said that the goal is to make a dent in rising specialty drug costs, adding that “there is more to be done.”