Cardinal Health Exec: How Adalimumab Biosimilars Can Reshape the US Health Care Industry

Fran Gregory, PharmD, MBA, vice president of emerging therapies at Cardinal Health, published her opinions on the future of biosimilars in the United States, foreshadowing greater adoption, accessibility, and provider acceptance as well as a transformation of the US health care industry.

Payers, patients, and employers are eager for more biosimilar competition in the adalimumab space, which welcomed 8 biosimilar competitors since January 2023, with 1 FDA-approved product left to launch (Abrilada). Of the $38.4 billon in projected health care savings during 2021-2025 that is projected due to biosimilar competition, over half of that is expected to come from biosimilars referencing Humira (adalimumab).

However, Gregory stressed that how quickly projected savings are realized will depend on multiple factors, including pharmacy benefit managers (PBMs) and payer pricing strategies, formulary coverage, biosimilar pricing, and provider willingness to prescribe these products.

Cardinal Health’s 2023 Biosimilars Report showcased that providers’ willingness to prescribe biosimilars vary by specialty and condition, with gastroenterologists being much more willing to prescribe adalimumab biosimilars compared with rheumatologists and dermatologists.

“At Cardinal Health, we are committed to changing these perceptions. By providing education to prescribers, partnering with payers to optimize acceptance, working to educate broadly through webinars and continuing education for healthcare professionals, and engaging in initiatives to keep the provider community aware of the pipeline, we continue to make progress in biosimilar awareness and confidence,” commented Gregory.

Interchangeability is also expected to play a role. Currently, only 1 adalimumab biosimilar (Cyltezo) has an interchangeability designation, with 4 other candidates expected to gain approval for it in the next couple years. Cyltezo has been well-favored by PBMs, with Express Scripts, Optum Rx, and Prime Therapeutics all announcing they will add the product to formulary.

However, while this does bode well for Cyltezo, other adalimumab products may not see the same benefits, especially since Cardinal Health’s report found at over 60% providers only felt comfortable prescribing an adalimumab biosimilar that is interchangeable.

“There have been many studies to evaluate the safety of switching to a biosimilar from a reference biologic. To date, none have found differences in safety, efficacy or the likelihood a drug will trigger an unwanted immune response. The same holds true for studies focused specifically on Humira and its alternative…. Cardinal Health will continue to help educate providers by sharing peer-reviewed literature supporting the safety, efficacy and cost-effectiveness of biosimilars,” said Gregory.

A further complication preventing adalimumab biosimilar adoption will be the variety of products, which can vary in concentration, citrate content, administration devices, and coverage options.

As adoption of biosimilars increase, they can impact patient accessibility to standard of care products for many chronic and life-threatening conditions as well as mitigate prescription drug spending, according to Gregory. However, to achieve the benefits, stakeholders across the health care industry will need to recognize and work to remove adoption barriers. Adalimumab biosimilars present an opportunity to better adoption strategies that allow for patients to have better clinical outcomes and less out-of-pocket costs.

Gregory concluded, “These are exciting times in the biosimilars space. As more biosimilars become available for even more life-threatening conditions, it’s easy to see a world where there will be more access to these medications at more affordable prices. When I think of the work that Cardinal Health is doing in this space, I only see positive change and growth as we continue to collaborate and accelerate the adoption of biosimilars and help improve the lives of patients.”