UnitedHealth Follows Competitors, Replaces Humira with Lower-Cost Biosimilars

UnitedHealth Group Inc. UNH reportedly announced on Tuesday that it will remove AbbVie Inc.’s ABBV blockbuster drug Humira from some of its preferred reimbursement lists starting January 1, 2025. The company will recommend lower-cost biosimilar versions instead.

This move is part of a larger trend in the U.S. pharmaceutical market, as health plans seek to cut costs by promoting alternatives to high-priced drugs.

Also Read: FTC Investigation Uncovers Anti-Competitive Practices By Handful Of Pharmacy Benefit Managers, Including CVS Health, UnitedHealth.

Reuters highlights that Amgen Inc’s AMGN Amjevita, managed by its pharmacy benefits unit, Optum Rx, is among the biosimilars covered under UnitedHealth’s lists for commercial health plans.

With this decision, Optum becomes the last of the three largest U.S. pharmacy benefit managers (PBMs) to exclude Humira.

Cigna Corporation CI announced last month that it would remove Humira from some of its lists in 2025, following a similar decision by CVS Health Inc’s CVS Caremark unit in April.

CVS’s action led to a swift shift, with more patients transitioning to Sandoz Group AG’s SDZNY SDZXF biosimilar version of Humira in just three weeks than in the previous 15 months combined.

Cigna plans to cover biosimilars like Boehringer Ingelheim’s Cyltezo, Simlandi from Teva Pharmaceutical Industries Ltd TEVA, and Alvotech’s ALVO products, including an unbranded version of Sandoz’s Hyrimoz, as replacements for Humira.

UnitedHealth noted that patients would still have access to Humira until the FDA designates the preferred biosimilars as interchangeable with the original drug, per the report. The FDA is expected to make this designation in 2025.

Despite the growing competition, AbbVie has managed to retain a dominant share of the U.S. Humira market throughout 2023. This has been achieved through favorable negotiations with PBMs, even as biosimilar alternatives from companies like Pfizer Inc PFE entered the market.

As per a Reuters report, Humira has still managed to retain over 80% of its patients even after facing lower-priced rivals in the U.S. over the past year.

Following their launch last year, pharmacy benefit managers largely influenced patient access, with minimal incentive for doctors to switch to these alternatives.

In May, Cantor Fitzgerald said AbbVie had positioned itself to absorb Humira biosimilar erosion and achieve modest operational revenue growth.

Price Action: UNH stock is down 2% at $587.07 at last check Wednesday.

Photo via Shutterstock

Disclaimer: This content was partially produced with the help of AI tools and was reviewed and published by Benzinga editors.

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