Samsung Bioepis' Humira biosimilar gaining traction in US market, totaling 4 US payers

Just a few weeks after the official launch of Samsung Bioepis and Organon’s Humira (ingredient: adilumab) biosimilar, Hadlima, in the U.S. market, it is quickly gaining traction, after being added to two large U.S. insurers.

This marks the fourth U.S. insurer to register the drug. Previously, Prime Therapeutics, and American insurance giant, Cigna Healthcare, added the biosimilar to its new formulary recommendations so that patients in the U.S. could receive insurance coverage for Hadlima prescriptions.

Organon announced on Tuesday through its second quarter financial report that Hadlima has been added to the formularies of two large U.S. insurers, UnitedHealthcare and Centene.

Thus far, Hadlima has been announced on the formulary listing of two pharmacy benefit managers (PBMs) including OptumRx and Express Scripts. 

“In the case of OptumRx, we have secured more than half of the lives through UnitedHealthcare and through Express Scripts, between Cigna and Prime Therapeutics, we've secured about a third of the lives,” said Organon CEO Kevin Ali in the second quarter earnings call on Tuesday.

In this regard, Ali also added that it had received official notification from insurer, Centene, about adding Hadlima to its formulary, which is expected to cover another 5 million lives through its separate PBM network. 

Centene is a private health insurer with annual sales of about 19 trillion won (approximately $14.4 billion) and a market capitalization of about 47 trillion won. Meanwhile, UnitedHealthcare's formulary is maintained separately by the insurer, as opposed to the  Optum Rx, the group's pharmacy benefit manager (PBM). 

In the American medical insurance system, PBMs and insurers, which act as intermediary managers, must each provide a list of drugs and treatments to determine insurance benefits for patients. Unlike the Korean national health insurance system, these companies contract with various insurers to manage drug costs, select and maintain drug lists, and review and pay drug claims in exchange for management fees and rebates from pharmaceutical companies.

Hadlima is a biosimilar to AbbVie’s original drug Humira, an autoimmune disease treatment for rheumatoid arthritis, spondyloarthritis, and psoriasis. 

After holding a 20-year monopoly over the market, AbbVie is expected to lose favor to a slew of biosimilars this year due to its lower cost. While Hadlima is quickly gaining favor, there is a flood of other Humira biosimilars such as Celltrion’s Yuflyma, and eight other biosimilars expected to also vie for a space in the heavily contested autoimmune disease market this year.