Docs discuss sluggish switch to Humira biosimilars, name preferred off-patent options

Spherix Global Insights has provided a different angle on AbbVie’s successful retention of Humira sales in the face of biosimilar competition, polling doctors about forces shaping the market and their preferred off-patent options.

AbbVie reported global Humira sales of $2.8 billion in the second quarter. That represented a 29% drop on an operational basis but meant Humira remained a major product more than one year on from the launch of the first biosimilar in the U.S. Spherix surveyed 313 physicians, split roughly evenly between gastroenterologists, rheumatologists and dermatologists, to understand what is happening.

Significantly more gastroenterologists than rheumatologists or dermatologists expressed favorable views of biosimilars, Spherix said. Nearly half of gastroenterologists proactively choose to prescribe biosimilar brands, the survey found, but rheumatologists and dermatologists have largely been driven to off-patent options by “external pressures.” Those pressures have intensified slower than some people expected.

One rheumatologist said two years ago they would have predicted Humira would only account for 10% of the market by late 2024. Yet, at the time of the survey in April, the rheumatologist wasn’t seeing that split nor encountering any issues when prescribing Humira. Another physician said they felt about 30% of patients were on biosimilars, with the rest staying on Humira.

The second physician also expected biosimilars to penetrate the market faster and to face “this whole tsunami of just lots and lots of work and just the sudden shift.” Yet, so far, the shift has “been odd,” the physician said in April, because “it's not every payer and it hasn't been as awful as I thought it would be.”

AbbVie expects to “maintain parity access to biosimilars for a significant majority of patient lives this year,” Jeffrey Stewart, the company’s chief commercial officer, said on an earnings call in July. Asked by an analyst about 2025, Stewart said Humira access “will certainly be lower than this year,” but AbbVie expects to maintain parity access for a “meaningful” portion of patients across all channels.

Spherix looked at which biosimilar brands stand to benefit as AbbVie loses access. Gastroenterologists still favor Amgen’s Amjevita, the first Humira biosimilar to launch in the U.S., but are gradually increasing their use of unbranded adalimumab, as sold by Sandoz, Boehringer Ingelheim and Biocon, and Samsung Bioepis and Organon’s Hadlima. Physicians in the other specialties are increasingly using Hadlima, too.

Specific biosimilar brand usage depends on what is covered by the patient’s insurance. As well as fighting among themselves, biosimilar manufacturers face competition from AbbVie’s Humira successors Skyrizi and Rinvoq. Stewart said AbbVie saw around 20% of patients move to drugs with other mechanisms, such as Skyrizi and Rinvoq, when they lost access to Humira.