The pharmacy benefit manager SmithRx has announced that through a partnership with the Mark Cuban Cost Plus Drug Company, it will offer Yusimry, an adalimumab biosimilar, for less than 90% of the cost of the reference product, Humira.
With multiple adalimumab biosimilars poised to enter the US market in July, pharmacy benefit managers (PBMs) are announcing their preferred products and how they will or won’t continue to cover the reference product (Humira).
SmithRx, which bills itself as a next-generation PBM with 100% pass-through pricing and advanced PBM technology, has announced it will offer Yusimry for less than 90% the list price of Humira beginning in July.1 The PBM will partner with the Mark Cuban Cost Plus Drug Company (Cost Plus Drugs).
SmithRx will offer Yusimry through Cost Plus Drugs’ online mail order pharmacy for $569.27 plus dispensing and shipping fees.1 In February, the PBM and Cost Plus Drugs announced a partnership to expand access to affordable medications for the PBM’s members.2
“Humira is often an employer’s top drug expense so offering a low-cost alternative will have significant impact,” said Jake Frenz, CEO and founder of SmithRx.1 “We’re excited to work with Cost Plus Drugs to bring this biosimilar to our members—and significantly reduce costs for them and their employers.”
Humira is the top-selling medicine of all time, and since its launch in the United States in 2003, the price has increased more than 500%, from $13,572 a year to nearly $90,000 annually.2
On June 1, Coherus BioSciences, the maker of Yusimry, announced it planned to launch the biosimilar product at an 85% discount to the originator.2 The list price will be $995 per carton of 2 autoinjectors compared with $6922 per carton of 2 autoinjectors for Humira.
“Our Yusimry list price is a clear response to the challenges and needs of patients faced with high-cost adalimumab treatments today,” Denny Lanfear, Coherus CEO, said in a statement.2 “We believe there is a large, unmet need for improved access and affordability in the US health care system that Yusimry can address with this pricing.”
Yusimry was approved in the United States December 2021, and it is a low-concentration, citrate-free product. The citrate-free formulation results in less pain at the injection site for patients. The first adalimumab biosimilar to hit the market was Amjevita on January 31, 2023. Amgen said Amjevita would have 2 tiers of pricing: one a 5% discount to the preference product and the other a 55% discount.3 The latter discount would be available when insurers did not take advantage of rebates and discounts through PBMs.
“We believe that Yusimry can be an affordable solution for patients who are uninsured, underinsured, or recently separated from Medicaid coverage, who experience the most difficult financial health challenges,” said Chris Slavinsky, Coherus chief business officer.2 “We also believe that employers and the employees on their health plans can experience significant savings by selecting Yusimry when it becomes available in July.”
Other PBMs have also announced plans for making adalimumab biosimilars available.3 OptumRx was the first PBM to announce it would include Amjevita and 2 other biosimilars, although there was no information on tiering or utilization management strategies.4
Prime Therapeutics said it would cover Humira and recommend its biosimilars to sit alongside the reference product on the preferred drugs list of the formulary.4 Cigna Pharmacy also said it would add adalimumab biosimilars as preferred products at the same position as Humira. However, neither had said which biosimilars would be available.4
“Biosimilars hold tremendous promise to improve the affordability of life-changing specialty medications, and this is part of our work to expand access to them and achieve lower costs for the employers and members we serve,” Katy Wong, chief pharmacy officer, Cigna Pharmacy, said in a statement at the time.5 “By placing biosimilars on our formularies in the same position as Humira, we’re also ensuring that physicians and patients have choice and flexibility as they assess these additional biosimilar therapies.”
1. SmithRx will be first PBM to offer Yusimry, a Humira biosimilar, for one-tenth the list price of Humira. Press release. June 13, 2023. Accessed June 13, 2023. https://www.globenewswire.com/news-release/2023/06/13/2687176/0/en/SmithRx-will-be-First-PBM-to-Offer-YUSIMRY-a-Humira-Biosimilar-for-One-Tenth-the-List-Price-of-Humira.html
2. SmithRx teams up with Mark Cuban Cost Plus Drug Company to reduce prescription drug costs for America’s patients and employers. Press release. February 22, 2023. Accessed June 13, 2023. https://www.businesswire.com/news/home/20230222005121/en/SmithRx-Teams-up-With-Mark-Cuban-Cost-Plus-Drug-Company-to-Reduce-Prescription-Drug-Costs-for-America%E2%80%99s-Patients-and-Employers
3. Joszt L. PBMs announce 2023 coverage plans for adalimumab biosimilars. AJMC.com. January 1, 2023. Accessed June 13, 2023. https://www.ajmc.com/view/pbms-announce-2023-coverage-plans-for-adalimumab-biosimilars
4. Joszt L. First Humira biosimilar, Amjevita, launches in the United States. AJMC.com. January 31, 2023. Accessed June 13, 2023. https://www.ajmc.com/view/first-humira-biosimilar-amjevita-launches-in-the-united-states
5. Cigna offering equal access to new biosimilars and Humira next year. Press release. December 5, 2022. Accessed June 13, 2023. https://newsroom.cigna.com/cigna-offering-equal-access-to-new-biosimilars-humira-next-year