How PBMs Are Reshaping Biosimilar Market Access
As biosimilars continue to redefine the specialty drug landscape, payers and their associated pharmacy benefit managers (PBMs) are executing new strategies to capture a larger share of revenue. PBMs are partnering with manufacturers to co-develop and commercialize their own private-labeled biosimilar products. This coordinated approach provides value to both parties, as it enables them to […]
Patient Access Barriers in 2025 and Beyond
The landscape of patient access has become increasingly complex, intensified by evolving channel dynamics, greater biosimilar investment, and legislative reform. As payers evolve their utilization management tactics, manufacturers must also become more sophisticated in their access strategies. To explore these topics, MMIT and The Dedham Group conducted the second annual State of Patient Access Survey […]
Increased Competition Drives Biosimilar Market Shifts
For the past decade, biosimilar adoption in the U.S. has proceeded at a relatively slow pace, due in large part to limited financial rebates for payers and provider preferences for biologics. Recent research suggests that utilization is finally picking up steam as more health plans place both biosimilars and their reference biologics on preferred formulary […]
Key Benefits of Early Market Access Planning
According to our 2024 State of Patient Access survey, 81% of pharma companies are launching their market access planning much earlier than they did five years ago. By Phase I, one-third of pharma companies are already engaged in market access research, with most pharma companies (54%) engaged by Phase II – III. What can manufacturers […]
When Payers Become Producers: Inside the Private-Labeling Trend
Vertical integration between payers, PBMs, specialty pharmacies, and providers has grown in the last decade, with more negotiating power concentrated among a handful of major players. Now insurers are adding production arms into the mix, following CVS Health’s bid to cash in on the race for Humira biosimilar market share. Adding a manufacturing arm brings […]
Connecting the Dots: Part D Design, the IRA, and Biosimilar Uptake
Although the biosimilar market is expected to continue growing over the next few years, adoption thus far has been somewhat slow and uneven. Recent research published in Health Affairs takes a look at how upcoming provisions of the Inflation Reduction Act (IRA) are likely to impact biosimilar coverage, concluding that both Medicare beneficiaries and the […]
Cordavis Could Benefit U.S. Biosimilars Market
It has now been over a year since the first Humira biosimilar, Amgen’s Amjevita, entered the U.S. market. Eight additional adalimumab biosimilars followed suit, offering lower-cost alternatives to AbbVie’s blockbuster drug via a variety of dual-pricing and discounting strategies. Some PBMs, including Express Scripts and Optum Rx, were quick to add some biosimilars to their […]
Humira Biosimilars: Pricing, Contracting and Interchangeability
This has been a significant year for the Humira (adalimumab) biosimilar market. AbbVie’s blockbuster drug Humira, an injectable used to treat a range of inflammatory conditions, saw the end of its 20-year, $200 billion monopoly in January. By the beginning of November, nine adalimumab biosimilars had made their market debut. Pharma manufacturers have been closely […]
Uncovering the Patient Journey: Four Ways that Real-World Data Offers Value
For manufacturers, building a static commercialization strategy will only take you so far. But infusing that strategy with real-world data (RWD)—consisting of medical claims, lab testing and pharmacy data, and electronic health records—provides a more holistic view of the patient journey. RWD fills in crucial missing puzzle pieces, especially when it’s integrated alongside payer coverage […]
Navigating the U.S. Patchwork of Biosimilar Laws
The FDA approved the first biosimilar more than eight years ago, and the agency continues to give the green light to multiple agents per year. In fact, 2023 could well be a landmark year in launches, spurred by multiple biosimilars of AbbVie’s Humira (adalimumab) entering the U.S. market. While the upcoming launches are a boon […]