On January 12, AbbVie announced that it had reached an agreement with the Trump administration on participation in its most favored nation (MFN) pricing initiative, and making certain medications available through its direct-to-consumer platform.
With the various agreements made with 15 other pharmaceutical companies, specific drugs were not disclosed. This is the first time in the short history of the MFN initiative that it involves a reference product with active biosimilar competition—that is, of publicly disclosed information.
However, the MFN (and Medicare maximum fair price for that matter) programs were explicit in their intent to avoid interfering with the biosimilar and generic marketplaces. For their part, AbbVie may simply be seeking another access channel to forestall fading Humira volume. It is not expected that the TrumpRx direct-to-consumer channel would be particularly strong.
What Is the MFN Price of Humira Likely to Be?
What would be the MFN price of Humira? Data on which the calculation derived from the administration’s international pricing index of countries with comparable economies are a bit dated, and the source has not been verified. Based on 2023 prices, Humira pricing ranges from $875 per 40 mg dose in Italy to $316 in France (of countries included in the MFN international index). Many of the adalimumab biosimilars are already providing deep discounts (some greater than 85%), to a price range of $450 to $693 for the same dose. At least one biosimilar is available through Mark Cuban’s Cost Plus at a 92% discount. What AbbVie offers under TrumpRx is unknown, but for cash paying buyers, Humira monthly cost will likely be hundreds of dollars, and largely unaffordable for most.
The point is that the biosimilar industry needs no additional impediment to its success, and most certainly, not in the adalimumab category. The reference product still retains the largest market share, and several adalimumab biosimilar makers are hanging on with miniscule volume.
In its rush to make TrumpRx MFN deals, the administration seems to have run roughshod over its own stated intention, to protect the biosimilar segment from harm. Simply, did AbbVie seek to include Humira in the arrangement, and the administration paid inadequate attention? Or did the administration seek to include Humira because of its boldface status, which would have been even stranger?
A Lack of Foresight or Lack of Principles?
Either way, this move sends a signal that the administration is conflicted about signing MFN deals for other reference drugs with active biosimilar competition. This isn’t an unintended consequence of the MFN policy; it’s a self-inflicted wound.
My original worry was that MFN, like Medicare’s maximum fair price negotiations, will discourage investment in biosimilar development. This was a problem for prospective biosimilar developers, I thought, not those with existing, approved biosimilars.
This seeming misstep is likely the result of the same “move fast and break things” mentality that has characterized this administration from the beginning of its second term. This was not a deeply considered move.
