UnitedHealth Group’s pharmaceutical benefits manager will cover up to three biosimilars that compete with AbbVie’s expensive drug Humira next year, the company revealed Tuesday.
Rheumatoid arthritis drugs are the highest-grossing pharmaceutical of all time and the biggest cause of drug price inflation, according to a congressional investigation. A year-long course of brand-name biologics can cost more than $84,000. Competing versions from other manufacturers will be available for the first time next year, allowing PBMs to pit manufacturers against each other for discounts.
By placing biosimilars on a par with Humira, OptumRx will allow members to continue using the brand-name drug or switch to a lower-cost alternative. OptumRx is the first PBM to reveal its plan to deal with the high-cost, brand-name drug as competitors hit the market. AbbVie did not immediately respond to a request for an interview.
Heather Cianfrocco, OptumRx CEO, said in a statement: “The upcoming wave of biosimilars represents an important opportunity to reduce costs and increase access to care for millions of people. . The company did not immediately respond to a request for an interview.
The subsidiary of UnitedHealth Group, the third largest PBM, processed 359 million prescriptions in the third quarter. OptumRx competes with CVS Health’s Caremark and Cigna’s Express Scripts, and together the trio covers 80% of insured consumers.
CVS and Cigna did not immediately respond to questions about whether they plan to include a Humira alternative in their formulary. The executives of both companies told investors this month that they expect the introduction of new biosimilars to reduce costs and improve accessibility.
PBMs have been anticipating biosimilars for Humira and other branded biologics as a way to limit spending, but may face objections from patients arising from questions inquire about the interchangeability of branded biosimilars and biosimilars.
