Study: Amjevita May Not Provide Much of a Discount

The price of Amjevita, the first Humira (adalimumab) biosimilar to reach the market, may not provide the level of cost savings it appears to, according to a recent report published in JAMA Network Open. 

Humira is a biologic medication indicated for a broad range of autoimmune conditions, such as rheumatoid arthritis, inflammatory bowel disease, and plaque psoriasis. Humira recently saw its 20-year market exclusivity come to an end. The first adalimumab biosimilar, Amgen’s Amjevita (adalimumab-atto), launched in the U.S. in January with a reported list price 55% below Humira’s.

A group of researchers, led by Sean R. Dickson of West Health Policy Center, wanted to quantify the net prices that payers see for the biosimilars compared with Humira.

“As new biosimilars for Humira enter the market, their prices are compared with the current price tag of Humira,” Inmaculada Hernandez, Pharm.D., Ph.D., study author and professor at the University of California, San Diego, explained to Formulary Watch. “We thought it was important to estimate how much insurers have been paying for Humira after discounts to have a more accurate comparison.”

To establish a comparison, the investigators had to determine the true net price of Humira. First, they generated a gross sales value, which meant estimating a monetary value for a scenario in which all Humira units from 2013 to 2020 had sold at the full list price. Then, they subtracted the manufacturer-reported net sales from the gross sales value to get a rough estimate of savings provided for Humira. To calculate the final estimate of rebates for Humira, the investigators took out government discounts, like Medicaid, from the discount value.

Ultimately, the researchers settled on an estimated rebate of $973 per unit of Humira, accounting for about 35% of the total drug cost. After applying the rebate estimate, the net price of Humira is $1,812, which is a more accurate prediction of the true cost of the drug for payers. Compared with Amjevita’s list price of $1,558, the results of the analysis showed that the cost savings comes to a 14% discount.

Notably, Amjevita is a biosimilar but it is not interchangeable with Humira. However, several new interchangeable alternatives for Humira are anticipated in the near future. The first interchangeable biosimilar is Boehringer Ingelheim’s Cyltezo (adalimumab-adbm), became available in July. It is priced at 5% to 7% below Humira.

Other interchangeable therapies are expected, including Pfizer’s Abrilada (adalimumab-afzb). But a potential new entrant — Alvotech’s high-concentration interchangeable biosimilar for Humira, AVT02 — received a complete response letter from the FDA in June 2023 because of issues related to a manufacturing facility.

When more interchangeable products do become available, they are likely to offer stronger competition in terms of list price compared with Amjevita, as they will actively promote themselves as cost-saving substitutes. Meanwhile, the estimates produced in this report contribute an additional perspective to the conversation about the cost of adalimumab and the potential savings offered by biosimilars.