Are Humira biosimilars about to make a financial impact? 

Biosimilar competition for AbbVie’s Humira started in January 2023 with pharmaceutical manufacturer Amgen’s release of Amjevita. By the end of 2023, it is expected that anywhere from 8 to 10 additional biosimilars to Humira will be available. Humira biosimilars could start to make a big financial difference over the next six months to a year. 

Manufacturers are taking different approaches to pricing to compete with Humira’s wholesale acquisition cost of roughly $90,000 per year. 

Amjevita launched with two pricing options: a 5% discount to Humira (with a higher rebate), or a 55% discount to Humira (with a lower rebate). Coherus Biosciences recently launched its biosimilar, Yusimry, at an 85% discount, bringing Yusimry in at around $13,000 per year. Separately, Mark Cuban Cost Plus Drug Company announced they will further discount Yusimry by offering a cash price of $7,400 per year direct to consumers (a 92% discount to Humira) plus dispensing and shipping fees. 

While pricing is a major factor for Pharmaceutical Benefit Managers (PBMs) considering Humira biosimilars for their formularies, concentration and interchangeability will also be key considerations. Currently, the majority of health plan members using Humira are on a high concentration formulation; however, AbbVie has both a high- and low-concentration formulation.

Amjevita and Yusimry are biosimilars for the low-concentration formulation and are not considered interchangeable with Humira – in other words, the pharmacist won’t automatically substitute the biosimilar when patients are filling a Humira prescription. Biosimilars that will be interchangeable in both concentrations are expected to launch by the end the year and will likely be competitive, if priced aggressively.

As more biosimilars are introduced, manufacturers are getting more aggressive with pricing in hopes of maintaining formulary placement. In addition, PBMs seem to be embracing Humira biosimilar strategies that will help employer health plan sponsors control costs while still providing options for plan members. 

For now, plan sponsors may want to encourage members to talk with their healthcare providers about biosimilars. For new users, the plan’s benefit design should incentivize the use of the lowest-cost option, whether Humira or biosimilar. However, extra consideration may be needed for current users of Humira until an interchangeable biosimilar option in the preferred concentration is available. Plan sponsors might consider a clinical exceptions process through their PBM based on where Humira is placed on the formulary.

As these changes occur, employers will need to assess the impact on their plan – including the extent to which savings from biosimilars could offset spending from other high-cost therapies. It’s also important to review pharmacy benefit contracts to ensure biosimilars are addressed in guarantees and contract terms. For many plan sponsors, Humira alone could account for a meaningful amount of their total pharmacy spend. Any increased competition, even if through rebates, can contribute to meaningful cost savings for plans.