Adalimumab, sold under the brand name Humira, has long been one of the best-selling drugs in the world. But its 20-year period without competition has ended, and despite its best efforts to delay its arrival, drugmaker AbbVie now faces increasing competition from biosimilars entering the market.
But a biosimilar about to be launched could be something of a game changer. Coherus BioSciences has announced plans to commercialize its biosimilar Yusimry (adalimumab-aqvh) at a cost of $995 for two auto-injectors. This represents an approximate 85% discount off Humira’s retail list price of $6922.
This price, however, is expected to drop further as Coherus has also revealed that it will be working with the Mark Cuban Cost Plus Drug Company (MCCPDC) to offer an even lower price. When Yusimry launches in July, it will retail for about $579 for two auto-injectors, making it the cheapest adalimumab biosimilar on the market.
“Coherus and Cost Plus Drug Company share a common mission, to increase access to high-quality medicines for patients at an affordable price,” said Dennis Lanfear, MBA, president, CEO and president of Coherus. “Mark Cuban and his team offer innovative solutions to healthcare problems, and Coherus is also a highly innovative company focused on unmet patient needs.”
He noted that with the biosimilar adalimumab’s price, this translates into a low list price approach. “We are delighted that Yusimry is a part of it, as the first bio they bring,” Lanfear said.
MCCPDC pricing is based on the cost of ingredients and manufacturing plus a 15% markup, a $3 drug dispensing fee, and a $5 shipping fee. The company has expanded its inventory from 100 generic drugs to more of 350 drugs since it launched in January 2022. Although MCCPDC is aimed primarily at people who pay cash for drugs, it accepts insurance from select plans. And even for people covered by other insurers, the cost of the Cuban company’s drugs could be less than their out-of-pocket costs if they went through their paymaster.
Yusimry’s low price is welcome, said Marcus Snow, MD, an assistant professor in the division of rheumatology at the University of Nebraska Medical Center, Omaha, but he stressed that it is still a very expensive drug. “For patients who can’t afford Humira due to poor insurance coverage and high out-of-pocket costs, it’s a welcome option,” Snow said. “But it’s also not clear how many patients who lack adequate health insurance coverage can afford to pay $579 a month out of pocket.”
Biosimilars are coming
As of early December 2022, the Food and Drug Administration (FDA) had approved seven Humira biosimilars, and Amgen launched the first biosimilar to hit the market, Amjevita, soon after. By July 2023, another half dozen are expected to enter the market, said Steven Horvitz, chief executive officer of EMC Analytics Group, a pharmaceutical research firm.
Horvitz agrees that the system is out of control, but it’s not clear what effect the low price will have on Coherus product. “Some insurers might say, ‘we want the lowest price and we don’t care about discounts,’ and we’ll go with it,” he said. “PBM [pharmacy benefit managers] they’re all focused on the economy, so we have to see how many of their major customers will ask for the lowest price.”
Amgen has more or less followed the status quo on pricing for its biosimilar, but with a twist. It’s offered at two different price points: $85,494 a year, which is just a 5% discount from Humira’s list price, or $40,497 a year, a 55% discount. However, to date, the lower price has not generally been granted by PBMs at a favorable formula placement. Plans using the more expensive biosimilar will get bigger discounts, but patients with coinsurance and deductibles will pay more out of pocket.
It is not yet known how Yusimry’s price will affect biosimilars ready for launch. “Will it give them pause for thought or will it make no difference?” Horvitz said. “Companies don’t disclose their prices before the fact, so we have to wait and see.”
The big PBMs didn’t jump at the opportunity to offer the biosimilar Coherus, but SmithRx, which bills itself as “next-generation pharmacy benefit management,” announced it will offer Yusimry to its members at more than 90% off.
“Unlike traditional PBMs, SmithRx prioritizes transparency and upfront cost savings. Humira is often an employer’s top drug expense, so offering a low-cost alternative will have a significant impact,” he said Jake Frenz, CEO and founder of SmithRx. “We are excited to work with Cost Plus Drugs to bring this biosimilar to our members and significantly reduce costs for them and their employers.”
Roxanne Nelson is a registered nurse and award-winning medical writer who has written for many major news organizations and is a regular contributor to Medscape.
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