Optum Rx, head of pharmaceutical benefits for UnitedHealth Group, said on Tuesday it would put three cheaper “biosimilar” versions of Abbvie’s expensive rheumatoid arthritis drug Humira “in the same position as the brand” on the drug list. PBM’s favorite known as a form.
Humira, approved by the US Food and Drug Administration 20 years ago, has for years been one of the country’s costliest drugs, generating more than $20 billion in sales for its maker, Abbvie in 2021. only. Humira was recently described by BioPharma Dive as “the most lucrative pharmaceutical monopoly in the history of the industry”.
Thus, Optum Rx’s decision next year will certainly create competition from cheaper biosimilars and should be quickly followed by other health insurers and PBMs given the potential savings to the US healthcare system. UnitedHealth has considerable clout in the healthcare industry as the nation’s largest healthcare company and parent to both health insurer UnitedHealthcare and Optum Rx, one of the nation’s largest PBMs.
Because Humira is so expensive at over $50,000 per year per patient, Optum Rx’s decision means thousands of patients could potentially be moved in 2023 to cheaper alternatives and save Optum Rx customers money. and to the US healthcare system potentially billions of dollars a year.
Optum Rx will continue to have Humira on its formulary in 2023 but will also “add up to three biosimilars to the formulary – in the same position as the brand – starting with the first biosimilar available in 2023”, revealed UnitedHealth and Optum Rx Tuesday at the 2022 HLTH Conference in Las Vegas.
There have already been a growing number of studies showing that biosimilar versions of Humira are just as effective and safe as Humira. So doctors and PBM executives see no reason why patients can’t choose the cheapest biosimilar versions.
“The availability of Humira biosimilars is one of the greatest opportunities in years to reduce costs and increase accessibility for consumers who need expensive specialty drugs,” OptumRx said in a statement Tuesday. “Our decision on biosimilars maintains a high quality of care while providing flexibility and choice for patients and providers, without interrupting treatment.”
More generally, biosimilar versions of drugs are expected to save health plans, government and consumers large sums of money as more are introduced in the coming years.
“The next wave of biosimilars is a critical opportunity to reduce costs and increase access to care for millions of people,” said Heather Cianfrocco, CEO of Optum Rx. “OptumRx fully supports the advancement of the biosimilars market as part of our commitment to providing patients and healthcare providers with high-quality, affordable flexibility and choice.
Humira, which treats autoimmune diseases including Crohn’s disease and rheumatoid arthritis, has generated nearly $200 billion in sales for its manufacturers over the past two decades.
Neither Abbvie nor its former parent company, Abbott Laboratories, discovered Humira. Abbott, then CEO of Miles White, discovered Humira through acquisition, a 2001 purchase of Knoll Pharmaceuticals for nearly $7 billion in cash. Abbott spun off its branded drug business in 2013 into what became Abbvie.
When Abbott purchased Humira, the biologic was already in the late stages of development and the latest clinical trials were giving the product a promising look. Knoll also brought Abbott several top-selling drugs, including the popular Synthroid thyroid treatment and other brand name prescriptions that have generated billions of dollars in sales over the years, making the acquisition of Humira less financially risky.
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