Thursday’s announcement comes after the insurance giant last week said it would remove AbbVie’s Humira from its major formularies starting in 2025, replacing the blockbuster with more affordable biosimilars.
Cigna’s Evernorth Health Services on Thursday announced that starting next year it will offer an interchangeable biosimilar to Johnson & Johnson’s Stelara with a $0 out-of-pocket cost for eligible patients of its specialty pharmacy.
The Stelara copycat will be produced by Evernorth’s affiliate distributor Quallent Pharmaceuticals and will be available to eligible patients through the company’s specialty pharmacy Accredo. The $0 price tag—which represents a more than 80% discount to Stelara’s list price—will apply to patients in Quallent’s copay assistance program and is expected to help consumers save $4,000 on average annually.
“We continue to believe in the power of biosimilars to achieve significant savings for patients and plan sponsors now and into the future,” Matt Perlberg, president of Evernorth’s pharmacy and care delivery businesses, said in a statement. “We are uniquely positioned to lower costs because of the leading capabilities we have in navigating the supply chain.”
According to Evernorth, there are currently more than 30,000 Accredo patients currently on Stelara. For these patients, as well as employers, unions and other health plan sponsors, the new Stelara biosimilar “represents an opportunity for significant savings.”
Cigna’s announcement on Thursday comes after the insurance giant last week said that it would remove AbbVie’s blockbuster antirheumatic therapy Humira from the major commercial formularies of its pharmacy benefit manager (PBM) Express Scripts.
As in the case of Stelara, Humira will be replaced “beginning next year” by low-cost biosimilars such as Boehringer Ingelheim’s Cyltezo, Teva’s Simlandi and Sandoz’s unbranded adalimumab-adaz. Quallent will also provide high- and low-concentration biosimilars. A Humira biosimilar is currently available on Accredo at $0 out-of-pocket cost, potentially leading to $3,500 in annual savings per patient, according to Evernorth.
Like Cigna, rival PBM giant CVS Caremark has removed Humira from its major national commercial formularies in favor of biosimilars. The PBM replaced Humira with Sandoz’s Hyrimoz, which CVS also partly owns through its subsidiary Cordavis.
PBMs have been under increasing regulatory and legislative scrutiny in recent months, particularly over their role in the increasing prices of prescription drugs in the U.S.
In July 2024, the Federal Trade Commission released a scathing interim report outlining the “substantial influence” that PBMs have over patient access to medicines and how these middlemen have become thoroughly vertically integrated with other players in the industry. As a result, PBMs often overcharge patients for treatments, the FTC contends.
PBM execs hit back at a recent House Oversight Committee hearing, insisting that they help bolster competition in the industry which ultimately lowers prices. Instead, PBMs blame the pharma companies for excessive drug prices due to the elaborate and complex patent thickets that they employ to keep generic competitors out of the market.
