The utilization of anti-inflammatory drugs continues to increase given the prevalence of autoimmune disease – it’s estimated that 1 in 5 Americans have an autoimmune disease – and the rich pipeline of biologics and biosimilars.
Humira, manufactured by AbbVie, is the highest-grossing drug of all time, generating revenue exceeding $200 billion throughout its two-decade reign and becoming a focal point for discussions about anti-inflammatory drug trends.
Since Humira lost patent protection in 2023, 14 biosimilar products have come to market, with more in development. Despite the increased competition and potential for significant cost savings for the healthcare market at large, adoption of anti-inflammatory biosimilars has been extremely low. Humira has maintained a strong revenue stream, reporting $14.4 billion in 2023.
Why is this the case? And how can PBM stakeholders more effectively manage this substantial portion of drug spend?
Strategies to Stay on Top
Several factors have contributed to Humira’s popularity. The range of autoimmune diseases Humira treats – it’s approved for 11 indications – along with aggressive marketing and patent strategies, among others, has helped establish and maintain market dominance.
Leveraging Patent Laws
AbbVie created a protective barrier of patents around Humira, delaying the entry of biosimilar alternatives in the U.S. market. This strategy, while controversial, follows a broader industry tactic of leveraging patent laws and rebates to protect high-cost specialty drugs from competition and ensure continued revenue from blockbuster medications.
Forming Unique Alliances
In 2023, AbbVie negotiated an agreement with Cordavis, a CVS Health company, to produce and distribute a co-branded Humira, further entrenching its market presence by ensuring availability through major healthcare providers.
Shifting Market Share to New Biologics
In 2019, AbbVie launched two additional anti-inflammatory products, Skyrizi and Rinvoq, and leads the pack when it comes to promoting these therapies to consumers. In a short time, these two biologics have racked up a total of 10 indications between them treating a wide range of autoimmune diseases.
| Skyrizi Treatment Indications | Rinvoq Treatment Indications |
| 1. Plaque Psoriasis (moderate to severe) 2. Psoriatic Arthritis 3. Crohn’s Disease | 1. Eczema 2. Rheumatoid Arthritis 3. Psoriatic Arthritis 4. Ankylosing Spondylitis 5. Non-Radiographic Axial Spondylarthritis 6. Ulcerative Colitis 7. Crohn’s Disease |
The company has high expectations for these newcomers, projecting a combined revenue of $16 billion in 2024 and $27 billion by 2027, surpassing Humira’s peak performance. It’s a keen strategy on AbbVie’s part to maintain leadership in the anti-inflammatory category despite increased competition.
Investing in the Future of Anti-Inflammatory Treatment
Recently, AbbVie invested $48 million (with another $665 million on the table) for global rights to an innovative treatment for chronic inflammation. Known as OSE-230, this therapy can resolve inflammation, rather than simply blocking pro-inflammatory pathways (like traditional anti-inflammatory therapies), giving it the potential to be another blockbuster product.
Biosimilar Adoption Outlook
Although there is a notable uptick in the utilization of certain biosimilars, such as oncology, the adoption of anti-inflammatory biosimilars remains low. Case in point, despite the availability of 14 biosimilar versions of Humira, the collective market share of these new products is only 1 percent.
It’s difficult to ignore the substantial cost savings afforded by biosimilars – discounts off Humira’s wholesale acquisition cost (WAC) range from 5 percent to 86 percent. At the end of the day, why should anyone pay more when there are clinically appropriate, lower-cost treatments available?
That’s exactly the message that some market disrupters, such as Mark Cuban Cost Plus Pharmacy, are working hard to get across. Cost Plus joined forces with Coherus to offer their anti-inflammatory biosimilar, Yusimry, at a savings of $5,927 compared to Humira.
While market share can be attributed to AbbVie’s efforts, biosimilar adoption is also influenced by PBMs – who determine what anti-inflammatory therapies are covered and thus control patient access – as well as healthcare providers, many of whom may need more education and outreach to help influence prescribing decisions. The big three PBMs have updated their formularies and added multiple biosimilar options, with CVS Caremark removing Humira altogether. It will be interesting to see how this affects utilization in the coming years.
With so many options available, it’s critical to have reliable analytics to inform decision-making as industry stakeholders navigate the coverage and management of anti-inflammatory drugs.
The Role of Analytics in Managing Drug Utilization
Automating analytics is crucial to making informed decisions around formulary placement to balance efficacy and cost efficiency. This is vital as new treatments like Skyrizi and Rinvoq become available, with projected revenues indicating a significant market impact.
Xevant’s analytics solutions offer a powerful tool to stay ahead of the curve. By leveraging data-driven insights, Xevant helps predict trends in drug utilization, evaluate the cost-effectiveness of new treatments, and optimize formulary decisions. This ensures patients have access to the most effective therapies and helps manage the financial implications of high-cost specialty drugs. In a sector marked by rapid innovation and shifting treatment paradigms, Xevant’s technology makes it easier to navigate anti-inflammatory drug management.
How can you better manage the utilization of high-cost specialty drugs? Ask us.
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