Cigna’s Express Scripts pharmacy benefits unit will include three biosimilar versions of AbbVie’s arthritis drug Humira on its preferred drug list. The biosimilars, including Hyrimoz and an unbranded version from Novartis’ Sandoz division, as well as Boehringer Ingelheim’s Cyltezo, aim to offer lower-cost alternatives. Patient access and potential out-of-pocket costs for biosimilars remain uncertain. The move intensifies competition with Amgen’s Amjevita and follows UnitedHealth Group’s Optum RX’s decision to cover Humira biosimilars. Other companies have also launched Humira biosimilars, but biosimilars generally offer smaller discounts than traditional generics.
Cigna’s Express Scripts pharmacy benefits unit has announced the addition of three biosimilar versions of AbbVie’s popular arthritis medication, Humira, to its list of preferred drugs. The biosimilars include Hyrimoz and an unbranded version of Humira from Novartis’ Sandoz generics division, as well as Boehringer Ingelheim’s Cyltezo.
Sandoz has priced its unbranded biosimilar, known as adalimumab-adaz, at an 81% discount compared to Humira’s current list price of $6,922 per month, while Hyrimoz will be offered at a 5% discount. Boehringer Ingelheim plans to launch Cyltezo at 5%-7% below the Humira list price.
Express Scripts will include these biosimilars as preferred brands on its formulary or drug reimbursement list. Pharmacy benefit managers (PBMs) like Express Scripts act as intermediaries between employers, health plans, and drug manufacturers. They negotiate rebates and fees and create formularies that determine which medications are covered by insurance and reimbursed by pharmacies.
Express Scripts did not provide information on whether patients would have the same access to Sandoz’s lower-priced biosimilar as the more expensive near copies of Humira on its formulary. Patient advocacy groups express concerns that if Cigna places Sandoz’s unbranded version on a different tier, patients may face higher out-of-pocket costs or additional criteria for accessing the drug.
The availability of these biosimilars in the U.S. market intensifies the competition for Humira, which began in January with the launch of Amgen’s Amjevita, already included on Express Scripts’ reimbursement list. UnitedHealth Group’s PBM unit, Optum RX, also announced in June that it would cover Sandoz’s two Humira biosimilars, along with Boehringer’s Cyltezo and Amgen’s Amjevita.
Unlike generic versions of conventional pills, biosimilars are complex biotech drugs made from living cells, making exact replication impossible. Consequently, biosimilars typically offer smaller discounts compared to traditional generics. Other companies, including Organon, Coherus BioSciences, and Celltrion, have also launched Humira biosimilars.