Is a Humira Biosimilar Price War Possible? (Plus the 10 Most Interesting Stories of the Week)

The Big News this week was obviously Friday’s release of final guidance on how the Centers for Medicare & Medicaid Services is going to implement price controls under the Inflation Reduction Act. 

I’m still parsing that, so if you want a deep dive there, you’re going to have to sign up for my daily email newsletter and wait until tomorrow. 

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This weekend is the starting gun for broad competition among Humira biosimilars, with multiple versions hitting the market as of July 1 (the first biosimilar, Amgen’s Amjevita, has been sold since January). 

So what will the influx of instant competition mean for the best selling medicine in the history of the world? Not much, apparently. Multiple media outlets pushed stories suggesting that the new biosimilars wouldn’t change the game.

But maybe there will be a price war coming:

• Coherus got headlines when it said it would price its Humira biosimilar at $995 a month, an 86% discount. It’s selling to Mark Cuban at an even lower price. 
• Organon/Samsung Bioepis priced their version at $1,038, an 85% cut, according to Reuters. 
• Sandoz, per Reuters, said its will cost 81% less. 
• Amgen offered a mere 55% discount. 

That’s only half the story, though. Sandoz is also launching a high-list-price version that is only 5% cheaper than Humira’s list price, mimicking Amgen, which also has a high-list option. Reuters said Boehringer Ingelheim’s product, the only one with an interchangeable designation, “will be priced similarly to the branded product.”

So the big question is whether PBMs will push the high-list versions or the low-list versions, and OptumRx gave some hints about how this would go down. The PBM giant will put both high-list and low-list biosimilars from Amgen, Sandoz and BI on their standard formulary … but not the low-list-only products from Coherus or Organon/Samsung Bioepis. Everyone seems to feel confident that health plans are going to choose the higher-priced version, because America.

Happy Fourth. 

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The Objectively Indisputable List of the Week’s 10 Most Interesting Value/Pricing/Access/Etc. News

1. Even though no one has necessarily figured out all of what is in the 198-page missive, the CMS guidance is an easy #1. 
2. Biomarin won approval for their Roctavian hemophilia gene therapy, and they did a great job talking about pricing on their investor call. I go into more detail here. 
3. It’s the end of an era at ICER, with Steve Pearson walking away from the group he founded at the end of the year. He’ll be replaced by his longtime deputy, Sarah Emond, so expect more of the same. 
4. Pharma efforts to stall the growth of contract pharmacies in the 340B program doesn’t seem to be getting Walgreens down. The company said, on its quarterly earnings call, that 340B would provide “a slight growth.” 
5. Americans are willing to pay a lot out of pocket to get new obesity meds, according to a new STAT/Harris poll, but they still think insurance companies should be the ones paying. Insurers are less certain. 
6. The CDC published a report detailing how badly we’re lagging in treating hep C in this country, despite having kick-ass, cost-effective meds. We are not remotely prepared, as a nation, to deal with health interventions that are both costly and cost-effective. 
7. It seems like the number of people paying attention to the cost-setting processes going on in Maryland and Colorado is way smaller than it should be, but if you want to hear what various stakeholders think, Maryland pushed out a deck that links to the comments they’ve received. 
8. It feels like employers seem to get the short end of the stick when dealing with PBMs, so the National Alliance of Healthcare Purchaser Coalitions put out a handy guide to doing battle with the PBMs. 
9. Ed Yong covered cancer drug shortages, which means that if you only read one thing on the subject, make it Ed Yong’s piece. 
10. Anyone who writes a story about Elon Musk, Mark Cuban, ivermectin and drug prices is just pushing out clickbait. But that’s the thing about clickbait: it’s hard not to click …