One of the world's best-selling drugs, Humira, is set to hit the market at the end of this month, as a competing version is set to be covered by the largest prescription benefits provider in the US.
It's possible that the decision could have billion-dollar consequences for the company. Rivals such as Amgen will be affected by it.
The calculation of what the best cost to clients will be is a difficult one. Rebates and discounts are offered by the makers of brand name medicines. Doctors and patients may be hesitant to switch to a different brand of medicine.
Alan Lotvin is the president of the pharmacy-benefits division of the company.
Lotvin said in an interview that the unit price of the drugs will be taken into account when calculating the price of the drugs.
If a drug plan ends up paying more for the original product because it adds a competing therapy, the total costs could go up.
The top arthritis drug is set for a US competitor.
The drug raked in $20.7 billion in revenue for the company. Amjevita will be launched in the US at the end of the month. There will be more copies of Humira later this year.
More than 100 million people have prescription benefits managed by the pharmacy giant. Lotvin said that the company's earnings will be boosted by the use of biosimilars.
Competing drug plans run by UnitedHealth Group Inc. and Cigna Corp. will add biosimilars to their approved medication list. The companies will not reward patients for using one over the other because they will all be treated the same.
Compared to generic versions of conventional oral medicines, biosimilars aren't exact copies of the complex biologic drugs they're meant to compete with They may have differences in how they're administered. Self-injection can be used to give the drug humira.
One of the variables that can influence adoption is whether the devices make it easy for patients to administer them. Is the chemical citrate in the drugs linked to pain after the injection? Patients and doctors can be influenced by the details of the new options.
In exchange for giving their drugs preferred placement on formularies, pharmacy benefit managers get concessions from manufacturers. Drug plans say the savings are passed onto clients.
Employers are being pushed to use cheaper drugs.
Lotvin said that they are going to look for ways for biosimilar manufacturers to be successful and get a return on their investment. It is going to be a real challenge to sell alternatives to Humira.
Lotvin said that the company might use different strategies for biosimilars in different plans. The approach may change over the course of the next two years.
He said there would be a lot of time for discussion, negotiation and decision making.
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