Cigna’s Evernorth to Offer Humira Biosimilar with No Out-of-Pocket Cost

Cigna_iStock, JHVEPhoto

Pictured: Cigna Group signage outside its office in Connecticut/iStock, JHVEPhoto

Cigna subsidiary Evernorth Health Services announced on Thursday that it will offer a Humira (adalimumab) biosimilar with no out-of-pocket cost via its specialty pharmacy Accredo.

The biosimilar products—which will come in high- and low-concentrations and which have the FDA’s interchangeability designation—will be available for “most patients” with no out-of-pocket cost through the copay assistance program of Evernorth’s distributor Quallent. The biosimilars will be available starting June 2024.

“Biosimilars can help drive significant savings for patients and their health plans,” Evernorth president Matt Perlberg said in a statement, adding that the company has leveraged its “leading capabilities … across the supply chain” to bring the biosimilar out-of-pocket costs down to zero and make the overall pharmaceutical experience “as simple as possible” for patients.

Evernorth in its announcement on Thursday estimates that the biosimilar products will cost around 85% lower than AbbVie’s Humira and will help save individual patients approximately $3,500 per year on average.

Evernorth’s new offering comes as Humira biosimilars appear to finally be making a substantial dent in the blockbuster’s market dominance in the U.S. Last week, analysts from Evercore ISI flagged a surge in the prescriptions for Humira biosimilars in the first week of April 2024. In the week ending April 5, biosimilar prescriptions jumped to approximately 8,300 from only 640 in the week ending March 29.

Sandoz’s biosimilar Hyrimoz accounted for 93% of this growth, whereas the other Humira biosimilars have mostly seen low and stagnant uptake.

The spike in prescriptions was driven by the decision of leading pharmacy benefit manager CVS Caremark to remove Humira from its major national commercial formularies in favor of biosimilars, effective April 1.

AbbVie is facing several biosimilar competitors including Amgen’s Amjevita, Celltrion’s Yuflyma and Alvotech and Teva’s Simlandi. However, despite implementing various strategies such as steep discounts and flexible pricing options, these companies have struggled to establish their footing in the U.S. market.

As of February 2024—prior to CVS taking Humira off its formularies—biosimilars had managed to take only 4% of the market share away from the branded reference product, according to a report from Samsung Bioepis. Humira retained control of 96% of the market.

In 2023, AbbVie reported $14.4 billion in Humira revenue, which, while still substantial, represents a 32% drop from 2022. The pharma attributed this decline to biosimilar competition.

Tristan Manalac is an independent science writer based in Metro Manila, Philippines. Reach out to him on LinkedIn or email him at tristan@tristanmanalac.com or tristan.manalac@biospace.com.

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