Humira, the benchmark arthritis drug from biopharma company AbbVie, is making a big comeback, although the potential for cost savings has a fairly low ceiling. However, AbbVie is not behind this revival; rival drugmaker Amgen has launched a biosimilar version of the 20-year-old drug dubbed Amjevita.
Amgen’s iteration of the drug debuted on the market with two-tiered pricing, the first of which offers a 5% discount to Humira’s monthly rate of $6,922. The alternative slashes the price by half, but may ultimately be unappealing to the pharmacy benefit managers (PBMs) in charge of recommending drugs that are generally well-covered by insurance providers. The majority of patients’ copay expenses are fixed as a percentage of list price, and are therefore expected to be based off of the higher of the two prices.
This is merely the tip-off of the Humira resurgence, as at least seven other biosimilar drugs are projected to arrive by this summer. Additionally, they all have the potential to be tied into discounted list prices. Whatever the case may be, healthcare industry experts concur that the U.S. private insurance system, a veritable mire of middlemen squabbling and rebates, will most likely mitigate the excitement of lower pricing, particularly for patients.
"The bottom line is it’s feasible that even if prices for Humira and biosimilars go down, this could be in the form of higher rebates to PBMs rather than actual lower prices that are passed onto patients," said Benjamin Rome, a Harvard Medical School drug-pricing researcher.