Cigna’s Express Scripts removed AbbVieThe company has removed Humira (adalimumab) from its major commercial drug lists, making way for lower-cost biosimilar alternatives.

Express Scripts did not provide a specific date for when these drug list changes will take effect. The company only said that the successful anti-rheumatic drug will no longer be included in major drug lists “starting next year.” Instead, the company will focus on access to “low-cost biosimilars,” including Boehringer Ingelheim’s Cyltezo (adalimumab-adbm), Teva’s Simlandi (adalimumab-ryvk) and Sandoz’s non-branded adalimumab-adaz injection.

The pharmacy benefit manager (PBM) also provides patients with an unbranded version of Cyltezo, as well as other interchangeable high- and low-strength biosimilars from Quallent Pharmaceuticals, a subsidiary of Cigna. Express Scripts has been offering biosimilars alongside Humira since February 2023.

In a statement, President Adam Kautzner said that by removing Humira from its core drug lists, Express Scripts will “leverage the savings offered by biosimilars and pave the way for access to the next wave of blockbuster prescription drugs.”

The change will also allow the PBM to ensure that patients have access to “the highest quality medications at the lowest possible cost and in the most patient-friendly manner possible,” Kautzner said.

Cigna follows in the footsteps of CVS Health. In April 2024, the company will REMOVED Humira from the main national drug lists of its PBS unit CVS Caremark in favour of Sandoz’s branded biosimilar Hyrimoz, which is co-marketed with Cordavis, also a subsidiary of CVS Health.

The move showed that access appears to be a much stronger driver than price when it comes to biosimilar market share. In the week after CVS Caremark removed Humira from its largest commercial lists, new biosimilar prescriptions Increase of 36%– although according to an investor note from Evercore ISI at the time, this was largely due to Hyrimoz.

The number of Hyrimoz prescriptions jumped in the week ending April 5, compared to just around 640 in the week ending March 29. Sandoz and Cordavis’ biosimilar accounted for half of all new prescriptions, while all other Humira biosimilars – despite flexible pricing and discounts of up to 86 percent – collectively shared the other half.

Market erosion has affected AbbVie’s sales. The pharmaceutical company recently reported a 30% decline in Humira sales compared to last year in the second quarter of 2024. Last month report Samsung Bioepis found that Humira’s biologics market share has shrunk to 82%.