Express Scripts to add Humira biosimilars to formulary as preferred products

Another major pharmacy benefit manager is adding Humira biosimilars to its formulary beginning next year.

Express Scripts, which is part of Cigna's Evernorth subsidiary, said Monday that it will add biosimilars for Humira to its largest formularies as preferred products available for patients with inflammatory conditions. Like other major PBMs, Express Scripts sees significant potential in biosimilars to help address the massive costs associated with specialty drugs.

Specialty drugs account for just 2% of prescriptions but drive half of drug spending.

In October 2021, Express Scripts announced that it would put Semglee, the first Food and Drug Administration-approved interchangeable insulin biosimilar, on its National Preferred Formulary for 2022. The company estimates that this move generated $20 million in savings in the first year.

“This decision helps us achieve lower costs for patients and plans while giving patients and providers choice and flexibility as additional biosimilars come to market,” said Harold Carter, chief pharma trade relations officer for Express Scripts, in the announcement.

“Lack of competition allows sky-high prescription drug prices," Carter added. "We can generate more competition in the inflammatory drug class by adding biosimilars to our largest formularies in the coming months and do what we do best—lower the costs of medications for the millions of people we serve.”

Express Scripts said it will continue to evaluate biosimilars for Humira as they are approved and expects adding these products to its formulary will pay off in significant savings.

News the PBM would add these products to its preferred formulary comes on the heels of news that Optum Rx plans to do the same beginning next year. Optum and Express Scripts are two of three massive PBMs that dominate the market alongside CVS Caremark.

Caremark hasn't made a formal announcement yet on its plans for Humira biosimilars, but in a statement to Fierce Healthcare last month it said that it similarly sees the promise in the coming wave of biosimilars and is "focused on making the best recommendation, not necessarily the fastest" for its formulary.

“Our formulary strategy remains to drive the lowest net cost of clinically efficacious products for our clients and members," Caremark said. "The upcoming introduction of up to 10 biosimilar competitors to Humira will further enable that strategy. We’ve been a PBM leader in creating a vibrant biosimilar market since adding Basalgar to our formulary in 2017.”