Credit: J.B. Reed/Bloomberg
Express Scripts is joining CVS Health in moving away from offering Humira as a standard prescription drug option for people with arthritis, Crohn's disease and other autoimmune disorders.
The pharmacy benefit manager said last week that it will shift to offering competitors to the popular drug through its main formularies, or covered drug lists.
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Humira is a brand name for adalimumab, an injectable natural substance, or "biologic medication," that can help patients cope with conditions that cause a patient's immune system to attack the patient's own body.
AbbVie, the manufacturer, has been selling the drug with a suggested retail price of about $7,000. The drug's patent expired in early 2023. Since then, many manufacturers have rushed to develop biosimilars.
Humira was the most expensive drug for U.S. employers in 2023, and it accounted for an average of $145 of plan spending per plan enrollee, according to Milliman.
GoodRx reports that patients now can get Humira for as little as $550 for a two-syringe carton. Some similar drugs sell for less than $200 for a comparable amount, but others cost more than $1,000.
Express Scripts will offer plan enrollees access to Boehringer Ingelheim's Cyltezo, Teva's Simlandi, Sandoz' Adalimumab-adaz and comparable products from Quallent Pharmaceuticals.
The history
CVS Health announced plans to remove Humira from its main formularies in the fall and completed the move in April.
UnitedHealth's pharmacy benefit manager, Optum Rx, added biosimilars to its formularies but has not evicted Humira.
Executives from AbbVie have been talking for months about PBMs' and payers' efforts to cut Humira spending.
AbbVie executives have said that they expect Humira to hold its own in the near term and that the company will focus on sales of other drugs that are still on patent.
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Allison Bell
Allison Bell, a senior reporter at ThinkAdvisor and BenefitsPRO, previously was an associate editor at National Underwriter Life & Health. She has a bachelor's degree in economics from Washington University in St. Louis and a master's degree in journalism from the Medill School of Journalism at Northwestern University. She can be reached through X at @Think_Allison.
