CVS Caremark Removes Humira from Key Reimbursement Formularies, Accelerating Biosimilar Adoption

Recently, Caremark, a subsidiary of CVS Health, the largest pharmaceutical retailer in the U.S., announced that starting from April, they would remove the former "blockbuster drug" Humira from some drug reimbursement lists and prioritize recommending biosimilar versions of the drug.

As the "old king of drugs," Humira, which has topped global sales for 11 consecutive years, has undeniably reached its twilight. Although 2022, its final year as the top drug, still saw it surpass Keytruda (K药) with a staggering revenue of $21.2 billion, now with the advent of numerous...

The influx of biosimilars has dimmed its glory, and the old "blockbuster drug" will face competition from all directions. Although AbbVie Inc. has tried various methods to fend off competitors' market entry, the removal from the reimbursement list this time is undoubtedly a heavy blow to the "old blockbuster drug."

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Relying on the reimbursement list to survive

In fact, last year, in 2023, Humira successfully mitigated the impact of biosimilars and retained most of its market share by relying on the reimbursement list.

Although the sales data for last year has not been released with the publication of the financial report, some preliminary data on prescription drugs offers a glimpse.

According to IQVIA, nearly 76,000 Humira prescriptions were written on average each week in the second half of last year. The closest competitor, Amgen, averaged just 417 weekly prescriptions for its biosimilar Amjevita. The gap between 76,000 and 417 is evidently large. This indicates that Humira’s patent cliff has not declined as rapidly as expected.

AbbVie stated in July this year that it was precisely because of these insurance reimbursements that Humira's sales fell 2 percentage points less.

However, following this move to remove from the reimbursement list, CVS Caremark's clients will save more than 50% on costs compared to 2022, which also means AbbVie’s sales will no longer be as smooth as before.

Of course, those who insist on Humira can still get Humira.

According to a statement from CVS Caremark, customers who wish to continue accessing Humira will be able to keep Humira on their formulary. The statement also added that Cordavis, a generic subsidiary of CVS, will launch another co-branded version of Humira in the second quarter, with the same active ingredients as the original Humira.

Interestingly, Cordavis, as a new brand of CVS Health, was just launched in August last year. However, at the time of its launch, Sandoz, which had been spun off from Novartis, had already reached a collaboration with Cordavis to jointly market Hyrimoz, a biosimilar of Humira.

And now AbbVie has joined the collaboration with Cordavis... With these combined efforts, CVS Health Corporation appears to be strongly promoting Cordavis.

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When Pharmacy Chains Start Monopolizing?

Because the United States has a "separation of pharmacy and medicine" healthcare system, CVS Health Corporation, as the largest oligarch in the pharmacy chain store industry, actually holds considerable influence in the pharmaceutical sales sector.

Therefore, it is quite intriguing that CVS Health launched Cordavis, its generic drug subsidiary, in August last year.

In terms of timing, the IRA bill's attempt to lower drug prices in the U.S. could be quite beneficial for the development of generic drugs.

Strategically, although CVS Health Corporation initially started as a chain pharmacy, its subsequent strategic planning focused on vertical development across the entire industry chain. Caremark, the company that removed Humira from its reimbursement list, was acquired by CVS Health in 2007 and operates in the pharmaceutical benefits sector.

Therefore, in this battle to encircle Humira, CVS Health may also want a piece of the pie.

Reference Source:

https://www.prnewswire.com/news-releases/cvs-caremark-accelerates-biosimilars-adoption-through-formulary-changes-302025679.html

https://www.nasdaq.com/articles/cvs-will-remove-abbvies-humira-from-some-drug-reimbursement-lists-in-april

Source: Biopharmaceutical Editor

Editor: Ren Luyun

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