Cheaper versions of Humira won't be adopted quickly

The companies that purchase drugs for employers and government programs don't anticipate switching quickly to cheaper copycats of the popular immunology drug Humira.

Why it matters: Humira, one of the world's most-used drugs that registered $20.7 billion in global sales in 2021, fended off competition for years for this very reason — to keep its U.S. market share high for as long as possible.

Driving the news: Pharmaceutical analysts at Bernstein interviewed eight executives who work at large pharmacy benefit managers about how they will handle Humira in 2023.

• PBMs create drug formularies, which are tiered lists of preferred drugs. Generics and biosimilars, which are near-identical versions of biologic drugs like Humira, are often preferred (although not always), and therefore result in cheaper copays for patients.
• Humira biosimilars are finally coming to the U.S. in 2023, even though they've been in Europe since 2018.
• But PBMs don't plan on booting Humira off their formularies or putting Humira in more expensive tiers right away. Instead, they plan to "adopt the biosimilars in a more gradual, stepwise fashion," according to Bernstein's report.

Between the lines: PBMs and health insurers don't want to make "the wrong product choice" since so many Humira biosimilars are coming out next year, Bernstein's analysts wrote.

• Many people who take Humira may not be keen on switching to different versions, so PBMs would rather start slow and "make the option available for employers who want to be more aggressive," the report said.

• The slow uptake — adding one or two biosimilars next to Humira — will also result in relatively modest savings, when compared with generics: PBMs interviewed by Bernstein believe Humira's net price will fall by 30% by the end of 2023 and by 50% at most by 2025.

The bottom line: Biosimilars are a hotly debated drug pricing topic, but they have struggled to take off in the U.S. Humira is yet another example of this.