Vizient Market Outlook Report Predicts Trends for Adalimumab Biosimilars in 2023

Vizient’s Pharmacy Market Outlook report outlined its predictions on how the emergence of adalimumab biosimilars will likely play out and what factors will play the biggest role in adoption. The report also discussed the pricing trends observed in other markets over the last few years as well as future markets to keep an eye on.

2023 is slated to be a game-changing year for biosimilars as the United States will see several biosimilars referencing Humira (adalimumab) enter the market and in the next 2 years, 5 agents, including Humira, will lose exclusivity.

Before 2022 closes, the report anticipated 6 FDA approvals: this high-concentration version of Hadlima (adalimumab biosimilar), TX05 (trastuzumab biosimilar), Cimerli (ranibizumab biosimilar), AVT02 (adalimumab biosimilar), EG12014 (trastuzumab biosimilar), CT-P16 (bevacizumab biosimilar), and Idacio (adalimumab biosimilar).

The approval of 3 more adalimumab biosimilars would bring the number of adalimumab biosimilars launching next year to 10. Vizient said that as the biosimilars penetrate the market, “a downward trend in the relative cost of commonly used biologics” should occur. However, the value may be lessened by the possible introduction of new versions of existing biologics, such as options for subcutaneous vendolizumab and infliximab, and new therapies in the inflammatory space.

Based on a recent survey Vizient conducted on how members utilize biosimilars, Vizient learned that acquisition cost, followed by payer placement, is going to be top deciding factor on whether to use a particular biosimilar instead of another biosimilar or the reference product. Vizient recommended engaging with payers prior to biosimilars launching as a way to better encourage biosimilar adoption.

The authors predicted that payers will subscribe to 1 of 3 strategies for adalimumab placement: prefer adalimumab biosimilars and exclude Humira, prefer Humira and exclude biosimilars, or offer both at parity. The first strategy has the benefit of allowing plans and their members to share in the savings because total prescription costs will be lower for biosimilars. The second would likely be implemented to prioritize rebates that are offered for Humira, which would benefit providers but would not affect members directly. The third approach provides the member with the most choices.

Despite debates on whether interchangeability designations will have an impact on biosimilar adoption, Vizient’s survey found that 48% of respondents felt that interchangeability was extremely important. Currently, only 1 adalimumab biosimilar has an interchangeable designation and 3 more have applications pending.

The authors predicted that uptake of adalimumab biosimilars will be slow during the first 6 months after market entry of the first one. This is because Amjevita will only be offered as a low-concentration formulation and will have no other competition besides the reference product until July 2023. Prescriptions for the high-concentration, citrate-free formulation of adalimumab accounts for 82% of Vizient member utilization of adalimumab, a trend that Vizient expressed will likely continue as biosimilar options become available.

The delivery method of the biosimilar may also have an impact on adoption because each product will have its own unique prefilled syringe or autoinjector device, some of which may be more user-friendly than others.

One of Vizient’s recommendations to help prepare for adalimumab biosimilars was providing education on biosimilars to physicians, clinic staff, and patients. “Implementing a biosimilar preference for patients starting therapy will initially help physicians and clinic staff to navigate these products and prepare them for switching current patients to biosimilars down the line,” the authors wrote.

Additionally, pharmacy members should make efforts to educate senior leadership, finance, managed care, and government relations colleagues on the implications of white bagging, which occurs when pharmacy benefit managers require certain high-cost drugs to be shipped from their own specialty pharmacies to practices and can lead to disruptions in patient care. Payers should also be transparent with which biosimilar and/or reference product will be covered.