Humira (adalimumab), a popular immunosuppressive medication, and its 22 biosimilars are largely absent from the formularies of Cigna’s Express Scripts, CVS Caremark and UnitedHealth Group’s Optum Rx.
Most FDA-approved biosimilars are not on the PBMs’ formularies, according to Drug Channels. They do include, however, a select few of biosimilars marketed by an affiliated company’s private-label business.
For example, a UnitedHealth Group segment runs Optum Rx and a new private-label business, Nuvaila. Optum Rx’s 2025 premium and select formularies have the low list price of Humira biosimilar Amjevita (adalimumab), which is branded from Nuvaila.
The other two PBMs have adopted similar strategies.
Cigna’s Evernorth segment operates Express Scripts and Quallent Pharmaceuticals, and Express Scripts’ 2025 formulary includes Quallent-branded Humira biosimilars. CVS Health owns Caremark and Cordavis, and its PBM’s formulary contains a Cordavis-branded biosimilar.
“Confusing? Absolutely. Profitable for the PBMs? Certainly. Good for plan sponsors and patients? Likely,” according to Drug Channels.
The PBMs are also featuring Stelara biosimilars, branded by private labels affiliated with their patient companies, this year.
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