UnitedHealth Group’s pharmacy profit manager will cover up to a few biosimilars that compete with AbbVie’s costly drug Humira next yr, the corporate disclosed Tuesday.
The rheumatoid arthritis treatment is the highest-grossing pharmaceutical of all time and the most important contributor to drug price inflation, based on a congressional investigation. A year-long course of the brand-name biologic drug can cost greater than $84,000. Competing versions from other manufacturers might be available for the primary time next yr, enabling PBMs to pit them against each other for discounts.
By placing biosimilars on the identical formulary level as Humira, OptumRx will allow members to proceed using the brand-name medicine or switch to a lower-cost alternative. OptumRx is the primary PBM to disclose the way it plans to cope with the high-cost, brand-name drug when competitors hit the market. AbbVie didn’t immediately reply to an interview request.
“The approaching wave of biosimilars is a pivotal opportunity to cut back cost and increase access to take care of hundreds of thousands of individuals,” OptumRx CEO Heather Cianfrocco said in an announcement. The corporate didn’t immediately reply to an interview request.
The UnitedHealth Group subsidiary, the third-largest PBM, processed 359 million prescriptions in the course of the third quarter. OptumRx competes with CVS Health’s Caremark and Cigna’s Express Scripts, and the trio collectively covers 80% of insured consumers.
CVS and Cigna didn’t immediately reply to questions on whether or not they plan to incorporate Humira substitutes on their formularies. Executives from each firms told investors this month that they expect the introduction of latest biosimilars to cut back costs and improve access.
PBMs have anticipated biosimilars for Humira and other brand-name biologics as a solution to contain spending, but can face pushback from patients arising from questions on the interchangeability of brand-name biologics and biosimilars.
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