Celltrion secures contracts with all 3 major US PBMs for Zymfentra

Celltrion said Monday that it has successfully secured a contract with the top three pharmacy benefit managers (PBMs) in the U.S., effectively covering about 75 percent of the U.S. insurance market for its new drug Zymfentra (ingredient: infliximab), known as Remsima SC outside the U.S.

The three largest PBMs in the U.S. -- CVS Health, Express Scripts, and Optum -- collectively manage about 80 percent of the market.

In April, Celltrion announced the inclusion of the Zymfentra in the formulary of two of the top three PBMs, including Express Scripts. Last Thursday, it also announced Zymfentra’s inclusion in the remaining one of the top three.

The company noted that due to contractual obligations, it cannot disclose the name of the latest PBM.

When asked why the coverage is not 80 percent, Celltrion told Korea Biomedical Review that the U.S. insurance market is divided into private and public sectors, with each of the three major PBMs negotiating separate contracts for formulary listings in both.

“Celltrion has completed agreements for private and public insurance with two of the large PBMs, including Express Scripts,” the company said. “For the third PBM, the company has finalized the public insurance contract, but is currently negotiating for the private insurance sector.”

Still, the company stressed it has managed to secure coverage for about 75 percent of the entire U.S. insurance market within five months of Zymfentra's launch in March.

"This provides us with a powerful foundation to expand prescriptions for Zymfentra in the world's largest pharmaceutical market,” the company said. “We will continue to work toward additional formulary listings while focusing on translating these contracts into tangible sales results for Zymfentra.”

Zymfentra, referencing the original drug Remicade developed by Janssen, treats a range of conditions, including rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, psoriasis, adult Crohn's disease, and ulcerative colitis.

Unlike the original medication, Zymfentra is administered subcutaneously, simplifying patient compliance.