CVS Caremark accelerates biosimilars adoption through formulary changes
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The strategic move by CVS Caremark to prioritize biosimilars over Humira in its formularies is a significant shift in the pharmaceutical landscape. This decision reflects the growing confidence in biosimilars as cost-effective alternatives to biologic drugs. The projected growth of the biosimilars market in the U.S. from less than $10 billion to over $100 billion within seven years underscores the potential for substantial market disruption. For stakeholders, the short-term implications include adjustments in drug procurement strategies and potential shifts in market shares among pharmaceutical companies. Long-term, there could be a broader impact on healthcare costs and insurance premiums, potentially making treatments more accessible to patients.
The agreement between CVS Health and AbbVie to supply a co-branded Humira product through Cordavis is an example of innovative collaboration in the pharmaceutical industry. It demonstrates CVS's commitment to providing multiple options to payors and patients, which could lead to increased competition and further price reductions. The impact on AbbVie's financials and market position will depend on the volume of the committed supply and the market's acceptance of biosimilars.
CVS Caremark's decision to remove Humira from its major national commercial template formularies in favor of biosimilars marks a pivotal development in the pharmaceutical supply chain. This shift is likely to influence distribution dynamics, with biosimilar manufacturers gaining an edge in distribution agreements. The seamless transition plan for members, including proactive communication and education, is critical for ensuring continuity of care and minimizing disruptions in the treatment of autoimmune conditions. The efficiency of this transition will serve as a case study for future biosimilar integrations into formularies.
Furthermore, the anticipated cost savings of more than 50% on adalimumab for clients in 2024 compared to 2022 could lead to a reevaluation of budget allocations within healthcare providers and insurance companies. This cost reduction may also incentivize other players in the market to adopt similar strategies, thereby increasing the rate of biosimilar adoption industry-wide.
The adoption of biosimilars in place of branded biologics like Humira aligns with broader healthcare policy goals of reducing drug costs and improving patient access to medications. The proactive approach by CVS Caremark in managing the transition, including the absence of a need for new prior authorization reviews, reflects an understanding of the administrative burdens often associated with healthcare delivery. By streamlining this process, CVS Caremark is setting a precedent that may influence future policy decisions and regulatory guidelines concerning biosimilar integration into the healthcare system.
The long-term benefits of this strategy potentially include a reduction in national healthcare expenditure on specialty drugs, which have been a significant driver of cost increases. This could lead to more sustainable healthcare models and potentially influence legislation aimed at curbing drug prices and expanding biosimilar adoption.
In much the same way that generic drugs are used as alternatives to branded drugs, biosimilars offer quality, safe, and effective treatment options that have no clinically meaningful difference from their reference products. A vibrant and competitive biosimilar market is essential to driving sustainable cost savings and options for consumers over the long term. The biosimilars market in the
"We are committed to accelerating the adoption of biosimilars and providing customer choice alongside a seamless member experience," said David Joyner, Executive Vice President, CVS Health and President of CVS Caremark. "Our customers want to have choices. By preferring biosimilars that have a significantly lower list price than their reference product, CVS Caremark is putting our customers in the driver's seat to best meet the health care needs of their members and lower drug costs."
The company also announced that AbbVie, as part of its continued commitment to access, has entered into an agreement to supply Cordavis, a CVS Health company, with a committed volume of co-branded Humira. This will provide another treatment option for adalimumab patients and aligns to the CVS Caremark focus on customer choice and seamless member experience. The Cordavis Humira product will be available in the second quarter. Cordavis Humira provides additional options for payors.
For members transitioning to a biosimilar, CVS Caremark will help ensure a seamless experience, including proactive member and prescriber notification of this change 60 days in advance, in addition to follow-up text message reminders and online education. CVS Caremark will meaningfully engage prescribers to guide them through appropriate next steps to help transition plan members. Because current Humira authorizations will be transitioned to the preferred biosimilar products, members and prescribers will not need to obtain a new prior authorization review with this product transition.
Autoimmune conditions, such as those treated by Humira, have been one of the greatest contributors to specialty drug growth over the last decade. CVS Caremark is again leading the market by actively taking advantage of this historic biosimilar opportunity, potentially saving our clients more than
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Media contact
Phil Blando
Phillip.Blando@CVSHealth.com
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SOURCE CVS Health
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