Cigna to remove AbbVie's Humira from some drug reimbursement lists next year

[August 27, 2024]  By Patrick Wingrove

(Reuters) - Cigna said on Monday it will remove AbbVie’s blockbuster rheumatoid arthritis drug Humira from some of its lists of preferred drugs for reimbursement in 2025, and recommend less pricey biosimilar versions of the medicine instead.

Cigna said Boehringer Ingelheim's Cyltezo, Simlandi from Teva and Alvotech, and an unbranded version of Hyrimoz from Sandoz will be covered on some lists that are managed by its pharmacy benefits unit Express Scripts.

Express will become the second major U.S. pharmacy benefits manager to stop recommending coverage of Humira, following similar action by CVS Health's Caremark unit in April. That move led more patients to switch to biosimilar versions of Humira in three weeks than had in the prior 15 months.

AbbVie did not immediately respond to a request for comment, but has previously said it expects to retain a lower share of the Humira market next year.

Pharmacy benefit managers, which act as middlemen between drug companies and consumers and negotiate volume discounts and fees, have come under increased scrutiny from U.S. agencies and lawmakers this year for their alleged role in keeping drug prices high. The companies have said they have a role in lowering drug costs and that only drugmakers can set the list prices for their medicines.

Test tubes are seen in front of a displayed Abbvie logo in this illustration taken, May 21, 2021. REUTERS/Dado Ruvic/Illustration/File Photo

Although 10 Humira biosimilars have launched in the U.S. since January 2023 from drugmakers including Amgen and Pfizer, AbbVie has managed to retain most of the market by negotiating favorable positions on insurance drug coverage lists managed by these middlemen.

Humira was once the world's biggest selling prescription medicine with peak sales of $21.2 billion in 2022.

Express Scripts and UnitedHealth Group's Optum Rx - two of the largest PBMs - chose to keep Humira on their reimbursement lists for 2023 and 2024.

Cigna in June made Humira biosimilars available with no out-of-pocket payment to eligible U.S. patients using its specialty pharmacy, but AbbVie lost virtually no market share as a result.

Optum Rx did not immediately respond to a request for comment on whether it planned to remove Humira from any reimbursement lists next year.

(Reporting by Patrick Wingrove; Editing by Bill Berkrot)

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