August 26 (Reuters) – Cigna (CI.N) announced on Monday that it will be removing AbbVie’s (ABBV.N) well-known rheumatoid arthritis medication, Humira, from several of its preferred drug lists starting in 2025. Instead, the insurer will endorse more affordable biosimilar alternatives, including Boehringer Ingelheim’s Cyltezo, Teva’s Simlandi, Alvotech’s offerings, and an unbranded version of Sandoz’s Hyrimoz.
This decision marks Express Scripts, Cigna’s pharmacy benefits management arm, as the second major U.S. pharmacy benefits manager to discontinue recommending Humira. CVS Health’s (CVS.N) Caremark unit had taken similar steps in April, resulting in a significant increase in patient switches to Humira biosimilars in just three weeks—more than the total switch rate over the previous 15 months.
AbbVie has yet to comment on Cigna’s decision but has previously indicated that it anticipates a reduced market share for Humira next year.
Pharmacy benefit managers, which mediate between pharmaceutical companies and consumers while negotiating discounts, have faced heightened scrutiny from U.S. regulators and lawmakers this year for their role in maintaining high drug prices. These managers argue that they help lower costs, though drug manufacturers ultimately set the list prices.
Since January 2023, ten Humira biosimilars have entered the U.S. market from companies such as Amgen (AMGN.O) and Pfizer (PFE.N). Despite this, AbbVie has successfully maintained a dominant market presence through strategic placement on insurance drug coverage lists.
Humira, which was once the top-selling prescription drug globally with peak sales reaching $21.2 billion in 2022, continues to be covered by other major pharmacy benefit managers such as Express Scripts and UnitedHealth Group’s (UNH.N) Optum Rx for the years 2023 and 2024. In June, Cigna began offering Humira biosimilars with no out-of-pocket costs through its specialty pharmacy, yet AbbVie’s market share remained largely unaffected.
