The adalimumab competition is officially open for business, and Amgen came out of the gate launching Amjevita in two WAC-based pricing options to appeal to a broad market.
One of the biosimilar industry’s main concerns is that adalimumab, the first biosimilar antibody, will be funded and managed through the pharmacy benefit. As such, pharmacy benefit managers (PBMs) will control much of the access, and PBMs base much of coverage on rebate contracts, especially in the adalimumab space. Therefore, maintaining a high wholesale acquisition cost and providing healthy rebates was a formula that helped AbbVie build $20 billion in US sales.
On the other hand, health plans and health systems frequently prefer lower list prices and minimal rebates to attain the same net cost; they don’t rake in the same rebate dollars that PBMs obtain.
Amgen has tried to please both customers. For their Amjevita launch, their base offering is a 5% lower WAC (i.e., $3,288 per 40-mg pen dose) than the reference product Humira®, with significant rebates to arrive at a lower net cost. Alternatively, Amjevita will be available at a WAC discount that is 55% below that of Humira today, without rebating (i.e., $1,557 per 40-mg pen dose). In either of these approaches, Amgen intends Amjevita to be highly competitive with AbbVie’s reference product. It is widely known that AbbVie rebates heavily off its current WAC price of $6,922/mo (chronic doses are administered every other week), estimates range from 40% to 60% (as contracting terms are proprietary, the average net price is not available).
It is anticipated that most of the Amjevita business will be managed through the PBMs, so the high WAC approach should predominate. It is also unclear at the moment if Amgen will widely offer the low-WAC pricing option.
In Other Biosimilar News
Biosimilar penetration in oncology practices exceed 90% in many cases, but a recent study indicated that although they are prescribed very frequently, oncologists are not necessarily highly informed about what biosimilars are. Researchers concluded that just over half of those surveyed understood that biosimilars are not the same as generic drugs, and only one-third knew that biosimilars and reference products do not share the same exact chemical structure and manufacturing process.