Biosimilar Adalimumab Adoption Could Yield Millions in Cost Savings, Study Finds
A study published in the Journal of Managed Care & Specialty Pharmacy evaluated the financial implications for US commercial health plans of incorporating biosimilar adalimumab into their formularies. The research presents a 3-year budget impact model for a hypothetical health plan covering 1 million members. The model assesses cost variations under different scenarios of patient transitions from reference adalimumab and other self-injectable tumor necrosis factor (TNF) inhibitors to the biosimilar adalimumab.
The study's findings indicate that even modest adoption of biosimilar adalimumab can lead to substantial cost savings. Specifically, a 10% patient conversion from the reference product, coupled with a 15% price reduction, resulted in savings exceeding $1 million. The authors note, "Cost savings more than $1 million were seen with a 10% conversion from reference adalimumab and a 15% price reduction from reference adalimumab."
The analysis also explores scenarios with varying rates of patient conversion. In a slow conversion model—starting at 10% in the first year and reaching 20% by the third year—the cumulative savings amounted to approximately $5.76 million. In contrast, a rapid conversion scenario—beginning at 50% and escalating to full conversion over 3 years—yielded savings of about $28.78 million. These projections underscore the financial benefits of prompt and widespread adoption of biosimilar adalimumab.
Beyond pharmacy costs, the study considers potential medical expenses associated with transitioning patients, such as additional office visits. The authors evaluated scenarios where patients required extra simple or complex visits due to the switch. The impact on the overall budget was minimal; even in the most intensive scenario—where all switching patients had up to 10 additional complex visits—the per-member-per-month cost increased by only $0.02.
Overall, these findings suggest that integrating biosimilar adalimumab into treatment protocols can offer significant cost advantages without imposing substantial additional medical costs. Clinicians are encouraged to consider biosimilar options as a strategy to reduce health care expenditures while maintaining therapeutic efficacy.
Reference
Chaplin S, van Stiphout J, Chen A, Li E. Budget impact analysis of including biosimilar adalimumab on formulary: A United States payer perspective. J Manag Care Spec Pharm. 2024;30(11):1226-1238. doi:10.18553/jmcp.2024.24036.
