Cigna Healthcare has expanded its formularies to include four biosimilars of Humira, aiming to increase access to affordable treatments and promote competition that lowers prescription drug costs. The inclusion of clinically effective biosimilars alongside Humira provides physicians and patients with choice and flexibility while reducing healthcare expenses. The move is expected to generate significant savings for integrated clients using Cigna Pharmacy Management. The adoption of biosimilars aligns with provisions in the Inflation Reduction Act, which encourages competition and cost reduction in healthcare.
To foster competition and reduce prescription drug costs, Cigna Healthcare is now covering the biosimilars of Humira, a widely used treatment.
Cigna Healthcare has incorporated four Humira biosimilars into its formularies, aiming to improve the affordability and availability of treatments for its members.
Cigna Pharmacy Management, the provider of pharmacy benefits for Cigna, has designated biosimilars as preferred products in its formularies.
According to Katy Wong, Chief Pharmacy Officer of Cigna Pharmacy Management, “Cigna Healthcare is dedicated to delivering greater value and lower costs to our customers and clients. Expanding access to specialty medications is an essential part of this commitment. By including clinically effective biosimilars in our formularies, alongside HUMIRA, we are ensuring that physicians and patients have choices and flexibility while promoting healthy competition and reducing healthcare expenses.”
Humira is primarily used for treating rheumatoid arthritis and other inflammatory conditions, but it can be a costly drug, even for individuals with health insurance coverage.
Starting from September 1, 2023, Cigna Healthcare will incorporate the following Humira biosimilars into its national, preferred, standard, performance, and legacy commercial formularies:
– Cyltezo (Boehringer Ingelheim): the first FDA-approved interchangeable biosimilar to HUMIRA, available in a low-concentration formulation.
– Adalimumab-adaz (Sandoz): high-concentration formulation, unbranded.
– Hyrimoz (Sandoz): high-concentration formulation.
– Hadlima (Organon): both high- and low-concentration formulations, added to the value, advantage, and total savings formularies.
Cigna Healthcare also plans to add these biosimilars to its formularies to generate significant savings for its integrated clients who utilize Cigna Pharmacy Management for their pharmacy benefits.
Evernorth, the health services business of the Cigna Group, predicts that competition from biosimilars could result in savings of $225 billion to $375 billion in total pharmacy spending over the next decade.
The Inflation Reduction Act includes provisions aimed at promoting the use of biosimilars to compete with biological products and reduce healthcare costs. Medicare typically pays the average sales price (ASP) plus six percent for a biosimilar product.
Under the Act, biosimilars with an ASP equal to or below the reference biological price will be available at the biological reference products’ ASP plus eight percent for the next five years.
As the cost of prescription medications continues to rise, the adoption of biosimilars could help mitigate the impact of high prices. While including biosimilars in pharmacy benefits may present challenges, particularly for employers, collaboration with health plans and pharmacy benefit managers can facilitate adoption, as advised by the National Alliance of Healthcare Purchaser Coalitions.