PBM Ventegra Adds Yuflyma Biosimilar as Preferred Product

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Yuflyma is on Ventegra’s public and private formulary on parity with the reference product Humira.

Ventegra, a PBM in Glendale, Calif., has added Celltrion USA’s Yuflyma (adalimumab-aaty) as a preferred product on its formulary effective the middle of September 2023. Ventegra covers more than 12 million lives, with a primary focus on Texas, Washington and California.

Yuflyma is biosimilar of AbbVie’s Humira that was approved in May 2023 and launched in July 2023. It is a high-concentration and citrate-free formulation. More than 80% of patients treated with Humira in the United States rely on a high-concentration and citrate-free formulation.

Yuflyma has a price of $6,576.50 per month, which is about 5% off Humira’s price. Celltrion offers $0 copay assistance through the Celltrion CONNECT Patient Support program, as well as patient assistance.

It is available in two device types — auto-injector and pre-filled syringe options. Yuflyma was approved for several indications including rheumatoid arthritis, juvenile idiopathic arthritis, psoriatic arthritis, ankylosing spondylitis, Crohn’s disease, ulcerative colitis, psoriasis, uveitis, and hidradenitis suppurative.

Francine Galante

Francine Galante

Yuflyma is on Ventegra’s formulary on parity with Humira and subject to prior authorization, Francine Galante, vice president of market access at Celltrion USA, told Formulary Watch in an interview.

Although Galante couldn’t share details of other PBM contracts, she did say that Yuflyma is now available to 25% of U.S. lives.

“Payers have been looking for relief in this therapeutic class,” she said. “Payers really are excited about the level of competition.”

Galante said going into 2024, the Humira biosimilar market could change quickly has payers become more comfortable with the biosimilars, and utilization may start to shift. She suggested that some manufacturers may even leave the market. “But Celltrion is here for the long-term,” she said.

Celltrion is seeking an interchangeability designation for Yuflyma, which is expected in the fourth quarter of 2024. So far, of the nine Humira biosimilars, only two have been approved as interchangeable. The first was Boehringer Ingeheim’s Cyltezo (adalimumab-adbm). And last week, Pfizer’s Abrilada (adalimumab-afzb) was granted an interchangeable status. Starting in late October 2023, Abrilada will be available at a list price that is 5% below the Humira list price. Additionally, later in 2023, Pfizer will provide the biosimilar at a second list price that is 60% below the Humira list price.

Amgen started the trend toward two-tier pricing when it launched Amjevita in January 2023 as the first Humira biosimilar. The higher price presumably has rebates available while the lower price is expected to come into play for higher deductible plans.

Related: Kaiser Permanente Expects to Save $300 Million Switching to Amjevita

Some plans are already starting to see savings from the Humira biosimilars. Kaiser Permanente, for example, has said that it expects to see $300 million in savings in 2023 by taking advantage of Amjevita’s 55% discount off Humira.

But a recent study in JAMA Network Open found that Amjevita may not provide the level of cost savings many expect. When rebates are factored in, Amjevita offers 14% discount of Humira, the researchers found. 

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