When CVS Caremark removed AbbVie’s Humira from its national commercial formularies back in April, biosimilar prescriptions picked up at a whirlwind pace. Now, Cigna’s Express Scripts is following suit in a move that could further chip away at Humira’s market share.
Express Scripts, which is Cigna’s pharmacy benefit unit, is removing branded Humira from its largest commercial formularies come 2025 in favor of biosimilar options from Teva, Sandoz and Boehringer Ingelheim.
“We’ve been thoughtful in developing a comprehensive approach that considers not just the formulary placement of biosimilars, but also each product’s clinical efficacy, interchangeability, available supply, dose, and concentration that will provide a seamless patient experience with these more affordable products,” Express Scripts President Adam Kautzner said in a release, adding that the company is “prepared to embrace the savings biosimilars offer."
AbbVie did not immediately respond to Fierce Pharma’s request for comment.
Express Scripts first added Boehringer Ingelheim’s Humira copycat Cyltezo and Sandoz’s Hyrimoz—plus Sandoz’s unbranded biosim—as preferred products to its National Preferred Formulary last July. The company’s parent group Evernorth, which is also owned by Cigna, previously estimated that biosimilar competition can save the U.S. up to $375 billion in total pharmacy spending over the decade.
While the onslaught of biosimilar competition has led to a sizable decline in AbbVie’s Humira sales, the originator's remaining 82% market share shows that supplanting the entrenched product won't be easy for the biosimilar marketers. In September, a Spherix Global Insights analysis revealed that prescribers had not yet “wholly warmed to these newcomers,” with dermatologists in particular showing the “highest degree of stated resistance to change.”
As it stands, Sandoz’s Hyrimoz has been responsible for “most biosimilar gains," scoring about four-fifths of Humira biosimilar prescriptions through April 25, a Samsung Bioepis report found. On the flip side, a rough launch for Boehringer Ingelheim’s Cyltezo prompted layoffs in its customer-facing Cyltezo teams in a pivot to a hybrid in-person and virtual sales model.
Meanwhile, at AbbVie, the company’s strategy to weather the impact of the Humira sales erosion with successors Rinvoq and Skyrizi is panning out as planned. Its recent quarterly Humira sales plunge of 29.8% was once again balanced out by double-digit growth for the two newer drugs, with Skyrizi steadily creeping up on Humira's level of sales.