The Impact of Humira Biosimilars: 5 Factors That Will Reduce Payer Costs

The use of biosimilar products in lieu of originator biologic products has been a hot topic of discussion since the first FDA approval of Zarxio (a biosimilar for Neupogen) in 2015. Since then over 30 new biosimilars have been FDA approved but the biosimilar market hasn't taken off as expected. It's estimated that $38.4 billion will be saved from biosimilar usage between 2021-2025 and there are 38 new biosimilars in the pipeline.

In July 2021 the FDA approved the first interchangeable biosimilar Semglee, which can be substituted for Lantus. In 2023, the second approved interchangeable biosimilar will be launched with the release of Cyltezo, interchangeable for Humira, the first of up to at least 12 different Humira biosimilars set to be released starting in 2023. This is anticipated to have a huge impact on the price of Humira, which grossed over $20 billion in 2021.

There will be fierce competition between AbbVie and competitor manufacturers as Humira biosimilars start launching in 2023. The battle for market share is expected to positively impact payers by lowering costs.

Here are 5 factors that could reduce payers' costs:

1. Lower net costs — Increased competition will likely result in overall lower net cost, with downward pressure on ingredient cost and potential for higher rebates.
2. Bundling of rebates — Manufacturers may bundle drug rebates within their portfolio to entice continued Humira utilization or drive new utilization through a biosimilar manufacturer's portfolio.
3. Prescriber detailing — AbbVie and biosimilar manufacturers will aggressively pursue tactical provider sales strategies around continuing Humira use or switching to a biosimilar.
4. Formulary positioning — Heading into 2023, Humira and at least some biosimilars could be co-preferred for many payers. OptumRx has already declared it will prefer three Humira biosimilars at parity with Humira in 2023.
5. FDA indications — Humira has coverage for 12 indications; as biosimilar manufacturers receive approval for the same indications, focus will shift more to overall net cost.