AbbVie’s Humira—a drug that treats inflammatory conditions like rheumatoid arthritis and Crohn’s disease—has earned the title of best-selling drug of all time, amassing more than $200 billion over the course of two decades.
And despite losing patent exclusivity in 2023 and facing competition from 10 biosimilars, Humira has held onto roughly 85% of the market share (though US sales have fallen about 32% in the past year), according to Divya Iyer, SVP of pharma manufacturer solutions at GoodRx.
Now, however, GoodRx is hoping to change that.
In July, the company announced a partnership with German drugmaker Boehringer Ingelheim to offer a 92% discount on adalimumab-adbm, the pharma giant’s Humira biosimilar. Using GoodRx’s cash discount, patients can get a two-pack of it for $550, which Iyer said translates to roughly a month’s worth of medication. Humira’s list price is around $7,000 for the same amount.
This lower-cost version from GoodRx and Boehringer Ingelheim could drive the uptake of the biosimilar, according to Iyer.
“We’ve got extensive GoodRx research that has shown that one of the key reasons for non-adherence, or people not picking up their prescription, is affordability. [Healthcare providers] have a vested interest in prescribing a drug that they know their patient can afford,” she said.
Plus, some physicians are hesitant to prescribe a biosimilar that isn’t interchangeable, meaning it can’t be substituted for the reference product at a pharmacy counter without a new prescription. Since the Boehringer Ingelheim biosimilar is interchangeable, providers may feel more confident prescribing it, Iyer added.
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The flip side. Andrew Mulcahy, a senior health economist at research institute Rand Corporation, said what’s going to significantly increase Humira biosimilar uptake is pharmacy benefit managers (PBMs) including the drugs on formularies.
So far, CVS’s Caremark, which is one of the three largest PBMs in the US, is the only one of the three to do so (and it’s worth noting that the top three PBMs control about 89% of the market). Caremark announced in January that, starting in April, it would remove Humira from its formulary and instead direct patients to biosimilars as a way to give customers more choices in their medication. In response, there was a noticeable spike in the number of patients using a biosimilar instead of the brand-name drug, Mulcahy said.
Humira biosimilars went from 5% of the market to 36% following Caremark’s move, according to data from Evercore ISI.
“That’s the kind of decision that could lead to much broader uptake over the long run,” he said.
But PBMs are generally not incentivized to include biosimilars on formularies because they receive larger rebates for higher-priced drugs, Iyer noted.
Where GoodRx’s discounted Humira biosimilar does stand to make a significant difference is for uninsured or underinsured patients, Mulcahy said, since most patients with insurance would already be paying less than $550 per month for name-brand Humira.
So while GoodRx’s move could benefit a small subset of the patient population, ultimately, “until insurers and PBMs aggressively push toward the biosimilars, biosimilar uptake will remain low,” Mulcahy projected.