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Could new biosimilars end Humira’s reign as the best-selling drug in history?

Thousands of patients with autoimmune diseases rely on Humira, at a list price of $6,600 a month, and could benefit from low-cost biosimilars that could save the health care system $9 billion a year, but will PBMs follow suit?

By Arthur Allen | September 26, 2023 at 11:52 AM
Humira

Tennessee last year spent $48 million on a single drug, Humira — about $62,000 for each of the 775 patients who were covered by its employee health insurance program and receiving the treatment. So when nine Humira knockoffs, known as biosimilars, hit the market for as little as $995 a month, the opportunity for savings appeared ample and immediate.

But it isn’t here yet. Makers of biosimilars must still work within a health care system in which basic economics rarely seems to hold sway.

For real competition to take hold, the big pharmacy benefit managers, or PBMs, the companies that negotiate prices and set the prescription drug menu for 80% of insured patients in the United States, would have to position the new drugs favorably in health plans.

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