Crohn’s Disease – Access & Reimbursement – Access & Reimbursement – Impacts of Biosimilar Adalimumab Launches in Autoimmune Disease (US)
2023 marks a pivotal year for the autoimmune space as numerous releases of biosimilar adalimumab challenge the market dominance of AbbVie’s Humira, one of the best-selling brands in the United States. The entry of Amgen’s Amjevita and the first interchangeable biosimilar, Boehringer Ingelheim’s Cyltezo, as well as adalimumab biosimilars from several other manufacturers, will have broad-ranging implications for Humira and likely other TNF-α inhibitors in the treatment of rheumatoid arthritis (RA), psoriasis, ulcerative colitis (UC), and Crohn’s disease (CD). This report explores specialists’ receptivity to biosimilars for these indications and MCOs’ coverage policies affecting Humira, its biosimilars, and other key brands in their largest fully insured commercial plans.
Questions answered
- How will the market entry of multiple biosimilars of adalimumab affect MCO tiering and restrictions on Humira and other TNF-α inhibitors for RA, psoriasis, UC, and CD?
- Will MCOs limit the biosimilars they cover or prefer, and what factors will most influence MCOs’ selection of preferred biosimilars?
- Under what circumstances and to what types of patients will physicians be most likely to prescribe a biosimilar, and how will they choose among the available products? How important is an interchangeable designation?
- Will prescribers specifically request that pharmacies dispense Humira to blunt an automatic substitution with an interchangeable biosimilar?
Content highlights
Geography: United States.
Primary research: Survey of 102 U.S. rheumatologists; survey of 41 U.S. managed care organization (MCO) pharmacy and medical directors (PDs / MDs). Limited results from prior surveys of 101 gastroenterologists and 101 dermatologists.
Key drugs covered: Humira, Abrilada, Amjevita, Cyltezo, Hadlima, Hulio, Hyrimoz, Idacio, Yuflyma, Yusimry
Key analysis provided:
- Reimbursement and contracting
- Access and prescribing
- Opportunities and challenges for biosimilars in 2024 and beyond
Product description
U.S. Access & Reimbursement provides integrated brand- and disease-level insight on reimbursement dynamics and the impact of U.S. payer policy on physician prescribing behavior in the market access environment, including up-to-date analysis of drug coverage and restriction policies and payer and prescriber perspectives on key marketed drugs and receptivity to emerging therapies.
