A survey of gastroenterologists, dermatologists, and rheumatologists found Amjevita had the most recognition, followed by Cyltezo, the only interchangeable biosimilar on the US market.
With competition finally hitting the US market, branded adalimumab (Humira) is finally losing market share, according to the third quarter update of the Special Topix: Biosimilars Today and Tomorrow from Spherix Global Insights.
Prior to Amgen’s adalimumab-atto (Amjevita) launching in the United States in January 2023, the reference product from AbbVie had enjoyed more than 20 years of exclusivity on the US market, bringing in more than $200 billion in total global sales, generating $20.7 billion worldwide in 2021 alone. Since Amjevita launched, 8 total adalimumab biosimilars have launched, with more approvals expected.
The biosimilars are available at a variety of discounts compared with Humira’s price. Amjevita launched with 2 tiers of pricing: one at a 5% discount to the reference product’s list price and the other pricing a 55% discount depending on whether patients have access to rebates and discounts through insurance. Yusimry, which launched in July, is available through the pharmacy benefit manager SmithRx at a 90% discount to Humira.
For its report, Spherix surveyed 80 dermatologists, 83 gastroenterologists, and 81 rheumatologists to understand their overarching sentiments, experiences, adoption rates, and future expectations for the adalimumab biosimilars.
Spherix found that Amjevita, which had 6 months of exclusivity before the other biosimilar competitors launched, was easily recognized by the specialists as an approved adalimumab biosimilar. However, among the remaining biosimilars that launching in July 2023, “awareness of Boehringer Ingelheim’s Cyltezo prevails across specialties, likely attributed to its unique position as the sole biosimilar granted interchangeability status by the FDA.”
Cyltezo is the only interchangeable biosimilar on the market; however, other manufacturers are pursuing the designation for biosimilars currently on the market.
There were some biosimilars that were more recognizable depending on specialty: Dermatologists and rheumatologists had strong recognition of Sandoz’s Hyrimoz and Biocon’s Hulio, while gastroenterologists recognized Coherus BioSciences’ Yusimry.
Although overall use of adalimumab has remained relatively consistent throughout 2023, the reference product’s share has declined steadily for all specialists. Adoption among rheumatologists has been the most “tepid,” according to Spherix.
While Cyltezo users are more prominent than the other July launches, its use still “pales in comparison to Humira and Amjevita.” In addition, the report detailed uncertainty that the July biosimilars would catch up to Amjevita,
“Amjevita had a good launch,” one rheumatology biologic coordinator was quoted as saying. “I’d rather stick to Amjevita and what I know instead of trying a new biosimilar.”
Regarding the potential of prescribing biosimilars, dermatologists were the most resistant, with half saying they were unlikely to prescribe a biosimilar over Humira. Dermatologists are also increasingly likely to write “dispense as written” when prescribing Humira, while others are more likely to prescribe the reference product and wait for any pushback from payers.
However, gastroenterologists and dermatologists both noted they are increasingly being asked to prescribe a biosimilar when prescribing Humira. “…a growing majority report that they will then just go ahead and prescribe the biosimilar option, with those willing to argue for Humira dwindling,” according to Spherix.
The findings are in line with a Cardinal Health report from earlier in the year, which found gastroenterologists and rheumatologists have the greatest familiarity with biosimilars and that dermatologists were most likely to say no discount would motivate them to prescribe a biosimilar over a reference product.
Dermatologists were also the most likely to list safety and efficacy as the top concern regarding adalimumab biosimilars. Gastroenterologists cited transitioning a patient from the reference product to the biosimilar as their top concern.