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OptumRx to Cover Amgen’s Biosimilar of Humira


OptumRx will offer Amjevita and two other biosimilars alongside Humira. OptumRx is the first large PBM to make public its plans for the seven Humira biosimilars that may come on the market next year.

An earlier version of this article was originally published on Nov. 17 on the Formulary Watch® website.

OptumRx plans to include Amgen’s Amjevita (adalimumab-atto) and two other Humira (adalimumab) biosimilars on its formulary next year, the CEO of the pharmacy benefit manager (PBM) announced this week at at the HLTH meeting in Las Vegas. Heather Cianfrocco, M.A., J.D., announced at a session of the HLTH2022 meeting this week.

“The coming wave of biosimilars is a pivotal opportunity to reduce cost and increase access to care for millions of people,” said Heather Cianfrocco, M.A., J.D., in a statement released in conjunction with the announcement. “OptumRx fully supports advancement of the biosimilar market as part of our commitment to providing patients and providers with high quality and affordable care, flexibility, and choice.”

The new biosimilars will be included on OptumRx's Select and Premium formularies, according to a company spokesperson. No information has been provided on tiering or utilization management strategies that might be employed.

OptumRx is the first of the large PBMs to make public its plans for the Humira biosimilars that are expected to hit the market next year.

A spokesperson for Prime Therapeutics, a PBM headquartered in the suburban Twin Cities, said in an email to Managed Healthcare Executive® earlier this week that the company had not made a decision yet about Humira biosimilars.

Similarly, spokesperson for CVS Caremark, the PBM subsidiary of CVS Health. said the company not made a specific decision on which biosimilar or biosimilars will be included on its formulary.

“With so many entrants to market in 2023, we expect the biosimilars category to be increasingly competitive and dynamic,” the CVS spokesperson said. in an email. “These agents differ in a number of ways — formulation, concentration, potential supply constraints, administration devices, price and the availability of copay assistance programs, to name a few — and all will be part of our thoughtful decision-making.”

Related: Humira, the biosimilars are coming, the biosimilars are coming!

Express Scripts did not respond to requests for information about how it is handling Humira biosimilars.

Humira, a drug prescribed to treat rheumatoid arthritis and a number of other autoimmune drugs, has sales figures of about $20 billion a year and is among top selling drugs, by sales revenue, of all time. The FDA starting approving Humira biosimilars in 2016, beginning with Amjevita, but the drugs have been kept off the market till next year because of patent disputes and other issues.

Amjevita is expected to come on the market in January. Six other Humira biosimilars are expected to come on the market during the second half of the year: Abrilada (adalimumab-afzb), Cyltezo (adalimumab-adbm), Hadlima (adalimumab-bwwd), Hulio (adalimumab-fkjp), Hyrimaz (adalimumab-adaz) and Yusimry (adalimumab-aqvh).

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