Sept 10 (Askume) – UnitedHealth Group (UNH.N) said on Tuesday it will remove AbbVie (ABBV.N) from its list of preferred drugs for reimbursement by Jan. 1, 2025.
UnitedHealth said Amgen’s (AMGN.O) Amzvita will join the list of biosimilars in commercial health plans administered by its pharmacy benefits unit Optum Rx.
Optum is the last of the three major U.S. pharmacy benefit managers to announce plans to phase out Humira. Together, these three benefit managers control about 80% of the U.S. prescription drug market.
Cigna (CI.N) announced last month that it would do soCVS Health announces partial removal of Humira from its list in April(CVS.N) Caremark unit has taken similar action. Sandoz within three weeks of the CVS move(SDZ.S) More patients are switching to Humira biosimilars than in the past 15 months .
Cigna said off-brand versions of Boehringer Ingelheim’s Cyltezo, Teva (TEVA.TA) and Alvotec’s (ALVO.O) Simlandi and Sandoz’s Hyrimoz would be added to its roster next year as alternatives to the Humira test.
UnitedHealth said patients will have a way to get coverage for Humira until the preferred biosimilar in its plans is designated as interchangeable by the U.S. Food and Drug Administration, meaning they can get it without consulting a doctor. United said the FDA expects to grant that designation in 2025.
In July, the FTC criticized pharmacy benefit managers, which negotiate fees and volume-based rebates with drug manufacturers and pharmacies on behalf of payers, for exerting undue influence on prescription drug prices.
The Pharmaceutical Care Managers Association, an industry lobbying group, responded that these companies provide value to the US healthcare system by lowering drug costs and increasing access to medications.
AbbVie has retained most of the U.S. market for Humira this year, even as companies such as Pfizer PFE.N will launch 10 biosimilars of the drug by January 2023. AbbVie has also gained favorable status in insurance drug coverage lists managed by pharmacy benefit managers.
Humira biosimilars now account for about 20% of the U.S. market, compared with 2.2% in the first quarter of this year, Barclays analysts said in a report on Monday.
AbbVie did not immediately respond to a request for comment, but said earlier this year it expects to maintain a low market share for Humira until 2025.
