CVS will become one of the first major pharmacies to pull the blockbuster arthritis drug Humira from some of its shelves, in a way that could save customers money.
In a press release today, the chain – which has 9,500 stores across the country – said the drug would be removed from the preferred list for reimbursement from April 1.
The drug, which costs $6,922 per month in direct costs, will be replaced by the biosimilar drug Hyrimoz, which costs $6,575, and an off-brand version, which costs $1,315.
The pharmacy chain is also working on its own co-branded version of the drug from AbbVie, the maker of Humira, which will be available later this year.
Humira – which contains the active drug adalimumab – is used to treat the autoimmune disease rheumatoid arthritis and has a 20-year patent, allowing AbbVie to make more than $200 billion from the drug.
Humira has had a monopoly on the market for twenty years, making owner AbbVie more than $200 billion. CVS is the first major chain to announce it is switching to an alternative
The chain – which has 9,500 stores across the country – said the shift was aimed at saving customers money
David Joyner, president of the CVS Caremark pharmacy benefits division, said, “By preferring biosimilars that have a significantly lower list price than their reference product, CVS Caremark puts our customers in the driver's seat to best meet their members' healthcare needs.” and lower drug costs.”
A CVS spokesperson told According to Reuters, the company expects most of its customers to switch their treatment once the original drug is taken off the shelves.
A biosimilar refers to a copy of a complex biotech drug, such as adalimumab, that is made by living cells and cannot be replicated identically.
CVS said Humira would still be available in its stores under certain insurance plans.
Humira was once the best-selling prescription drug in the world, with peak sales of $21.2 billion in 2022.
AbbVie managed to extend its monopoly, which was set to expire in 2016, through January 2023, allowing them to block alternatives while raising prices.
But as alternatives become more readily available, customers and pharmacy chains can now sell cheaper versions of the drug.
Adalimumab is an immunosuppressant used to treat many inflammatory conditions in adults, including rheumatoid arthritis, psoriatic arthritis, and plaque psoriasis, among others.
It is estimated that more than 11 million Americans suffer from these conditions, with approximately 313,000 people having symptoms severe enough to be prescribed Humira.
The drug is given as an injection into the front of the thighs or lower abdomen every other week.
It works by preventing the protein TNF from binding to and attacking healthy cells, which can cause the inflammation and pain associated with rheumatoid arthritis.
Swiss drugmaker Sandoz supplies the unbranded version of Humira for both CVS and Indian pharmaceutical company Biocon.
Although nine Humira biosimilars were launched in the US last year by drugmakers including Amgen, Pfizer and Boehringer Ingelheim, AbbVie has managed to retain most of the market by negotiating favorable positions on insurance drug coverage lists.
According to data from marketing company IQVIA, an average of almost 76,000 Humira prescriptions were written per week in the second half of last year. Its closest competitor, Amgen, received an average of 417 prescriptions per week for its biosimilar Amjevita.
This latest announcement comes after CVS said people who fill prescriptions at pharmacy locations may soon pay less for their medications as its business model is overhauled.
Currently, what customers pay for drugs and how much the pharmacy receives is determined by middlemen called pharmacy benefit managers, who negotiate drug manufacturers' reimbursements to insurers.
The complex reimbursement formula is not directly based on what pharmacies pay for specific medications.
The existing model allows pharmacies to receive higher rates on certain medications, with that margin used to subsidize losses on other prescriptions.
Under the new plan, CVS pharmacies will be reimbursed based on the amount CVS paid for the medication, as well as a fixed surcharge and a lump sum to cover the services involved in filling and dispensing the prescription.
Humira isn't the only drug undergoing a generic overhaul under its new business model.
Millions of Americans could soon be forced to live without life-saving medications after pharmaceutical giant GSK announced it would be pulling an asthma drug from its stores.
Flovent, the most prescribed inhaler for people with asthma, will no longer be available in pharmacies from January 1.
The drug's manufacturer, GSK, announced it would discontinue its branded inhaler and create an “authorized generic” version.
The generic drug will be an identical version of the brand Flovent, which is taken daily to help prevent asthmatic symptoms, GSK said.