HUMIRA COPAY ASSISTANCE PROGRAM DRIVER

This may become even more important as AbbVie is now limiting its patient copay assistance for Humira if a PBM employs co-pay accumulator or maximizer programs, which do not count such assistance toward deductibles. There is also value for patients as well because Amgen is offering patient assistance through the Amjevita SupportPlus Co-Pay Program with $0 copays. Generating competition in a category with significant financial impact for plans is promising.

HUMIRA COPAY ASSISTANCE PROGRAM DRIVER

Humira has been a top cost driver in pharmacy spend for most plans. “PBMs may go the rebate route if they think the rebates could be higher,” she said. This would mean, she said, that Amgen is anticipating giving rebates of at least $40,000 - the difference between Humira’s list price and the 55% discount off that price. This is probably one of the deepest discounted prices that we’ve seen.” “Traditionally biosimilars have come to the market 10% to 30% lower than the list price of the reference product. The 55% discount off Humira was surprising, Rayburg said. “The 5% model allows for PBMs to collect rebates that go to the payers and the 55% discount lowers the price and provides access for those in a high-deductible, consumer directed health plan,” she said in an interview with Formulary Watch.

The pricing model is meant to provide options for all payers, including commercial and government, as well as for private access to patients, said Renee Rayburg, RPh, vice president, specialty clinical consulting, Pharmaceutical Strategies Group (PSG).

Humira copay assistance program