Cigna to remove AbbVie's Humira from some drug reimbursement lists next year

Alvotech SA

26/08/2024 17:32

By Patrick  Wingrove
       Aug 26 (Reuters) - Cigna  CI.N  said on Monday it will
remove AbbVie’s  ABBV.N  blockbuster rheumatoid arthritis drug
Humira from some of its lists of preferred drugs for
reimbursement in 2025, and  recommend less pricey biosimilar
versions of the medicine instead.
    Cigna said Boehringer Ingelheim's Cyltezo, Simlandi from
Teva  TEVA.TA  and Alvotech  ALVO.O , and an unbranded version
of Hyrimoz from Sandoz  SDZ.S  will be covered on some lists
that are managed by its pharmacy benefits unit Express Scripts.
    Express will become the second major U.S. pharmacy benefits
manager to stop recommending coverage of Humira, following
similar action by CVS Health's  CVS.N  Caremark unit in April.
That move led more patients to switch to biosimilar versions of
Humira in three weeks than had in the prior 15 months.
    AbbVie did not immediately respond to a request for comment,
but has previously said it expects to retain a lower share of
the Humira market next year.
    Pharmacy benefit managers, which act as middlemen between
drug companies and consumers and negotiate volume discounts and
fees, have come under increased scrutiny from U.S. agencies and
lawmakers this year for their alleged role in keeping drug
prices high. The companies have said they have a role in
lowering drug costs and that only drugmakers can set the list
prices for their medicines.
    Although 10 Humira biosimilars have launched in the U.S.
since January 2023 from drugmakers including Amgen  AMGN.O  and
Pfizer  PFE.N , AbbVie has managed to retain most of the market
by negotiating favorable positions on insurance drug coverage
lists managed by these middlemen.
    Humira was once the world's biggest selling prescription
medicine with peak sales of $21.2 billion in 2022.
    Express Scripts and UnitedHealth Group's  UNH.N  Optum Rx -
two of the largest PBMs - chose to keep Humira on their
reimbursement lists for 2023 and 2024. 
    Cigna in June made Humira biosimilars available with no
out-of-pocket payment to eligible U.S. patients using its
specialty pharmacy, but AbbVie lost virtually no market share as
a result. 
    Optum Rx did not immediately respond to a request for
comment on whether it planned to remove Humira from any
reimbursement lists next year.
   
    

 (Reporting by Patrick Wingrove
Editing by Bill Berkrot)
 ((Patrick.Wingrove@thomsonreuters.com;))