CVS Caremark accelerates biosimilars adoption through formulary changes

Today CVS Caremark®, a CVS Health® (NYSE: CVS) company, announced the continuation of its efforts to expand adoption of biosimilars. Effective April 1, 2024, Humira® will be removed from our major national commercial template formularies and Humira biosimilars will be covered. Humira will continue to be an option for its customers with Choice and Standard Opt Out commercial formularies. Commercial formularies are the drug lists used by employers, unions and health plans for prescription drug coverage.

In much the same way that generic drugs are used as alternatives to branded drugs, biosimilars offer quality, safe, and effective treatment options that have no clinically meaningful difference from their reference products. A vibrant and competitive biosimilar market is essential to driving sustainable cost savings and options for consumers over the long term. The biosimilars market in the U.S. is projected to grow from less than $10 billion in 2022 to more than $100 billion by 2029.

“We are committed to accelerating the adoption of biosimilars and providing customer choice alongside a seamless member experience,” said David Joyner, executive vice president, CVS Health and president of CVS Caremark. “Our customers want to have choices. By preferring biosimilars that have a significantly lower list price than their reference product, CVS Caremark is putting our customers in the driver’s seat to best meet the health care needs of their members and lower drug costs.”

The company also announced that AbbVie, as part of its continued commitment to access, has entered into an agreement to supply Cordavis, a CVS Health company, with a committed volume of co-branded Humira. This will provide another treatment option for adalimumab patients and aligns to the CVS Caremark focus on customer choice and seamless member experience. The Cordavis Humira product will be available in the second quarter. Cordavis Humira provides additional options for payors.

For members transitioning to a biosimilar, CVS Caremark will help ensure a seamless experience, including proactive member and prescriber notification of this change 60 days in advance, in addition to follow-up text message reminders and online education. CVS Caremark will meaningfully engage prescribers to guide them through appropriate next steps to help transition plan members. Because current Humira authorizations will be transitioned to the preferred biosimilar products, members and prescribers will not need to obtain a new prior authorization review with this product transition. 

Autoimmune conditions, such as those treated by Humira, have been one of the greatest contributors to specialty drug growth over the last decade. CVS Caremark is again leading the market by actively taking advantage of this historic biosimilar opportunity, potentially saving our clients more than 50% on adalimumab in 2024 vs. 2022 when Humira was the sole option.

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