Mirroring fellow pharmacy benefit manager CVS Caremark, Cigna’s Express Scripts is taking Humira off its major commercial formularies starting next year and focusing on more affordable biosimilar options.
Cigna’s Express Scripts is removing AbbVie’s Humira (adalimumab) from its major commercial formularies, making way for more affordable biosimilar alternatives.
Express Scripts did not provide a specific date when these formulary changes will take place, only announcing that the blockbuster antirheumatic therapy will no longer be on its largest formularies “beginning next year.” Instead, the company will focus on access to “low-cost biosimilars,” including Boehringer Ingelheim’s Cyltezo (adalimumab-adbm), Teva’s Simlandi (adalimumab-ryvk) and Sandoz’s unbranded adalimumab-adaz injection.
The pharmacy benefit manager (PBM) also provides patients with an unbranded version of Cyltezo, as well as other high- and low-concentration interchangeable biosimilars from fellow Cigna subsidiary Quallent Pharmaceuticals. Express Scripts has been offering biosimilars alongside Humira since February 2023.
President Adam Kautzner in a statement said that in removing Humira from its major formularies, Express Scripts will “embrace the savings biosimilars offer and pave the way for access to the next wave of prescription drug blockbusters.”
The change will also allow the PBM to ensure that patients have access to “the highest quality drugs at the lowest possible cost in the most patient-friendly way,” Kautzner said.
Cigna is following in the footsteps of CVS Health. In April 2024, the company removed Humira from the major national formularies of its PBS unit CVS Caremark in favor of Sandoz’s branded biosimilar Hyrimoz, which is being co-marketed by Cordavis, also a CVS Health subsidiary.
The move revealed that access appears to be a much stronger driving factor than pricing when it comes to the biosimilars’ market share. In the week after CVS Caremark took Humira off its biggest commercial lists, new biosimilar prescriptions spiked 36%—though this was largely due to Hyrimoz, according to an investor note from Evercore ISI at the time.
Prescriptions for Hyrimoz skyrocketed to 8,300 new prescriptions in the week ending April 5, versus just around 640 in the week ending March 29. Sandoz and Cordavis’ biosimilar was responsible for half of all new prescriptions, whereas all other Humira biosimilars—despite offering flexible pricing options and discounts as steep as 86%—together split the other half.
Market erosion has been hurting AbbVie’s revenue, with the pharma recently reporting a 30% year-over-year decline in Humira sales in the second quarter of 2024. Last month, a report from Samsung Bioepis found that Humira’s biomarket share has shrunk to 82%.
