Boehringer Ingelheim’s Cyltezo has a slight competitive edge over other concurrent biosimilar launches on certain key performance metrics, though prescriber future projections show little differentiation in use among the recent entrants.
Exton, PA, September 14, 2023 — This summer ushered in the highly anticipated introduction of a multitude of additional adalimumab biosimilars to the dynamic US immunology market landscape. In response to this pivotal development, Spherix Global Insights conducted research involving a robust sample of US healthcare specialists, including dermatologists (n=80), gastroenterologists (n=83), and rheumatologists (n=81). This in-depth research delved into their overarching sentiments, experiences, adoption rates, and future expectations regarding the ten newly launched adalimumab biosimilar offerings. The latest insights from the third quarter update of the Special Topix™: Biosimilars Today and Tomorrow service uncovers a noteworthy trend: the continued erosion of AbbVie’s Humira in favor of a growing embrace of these diverse biosimilars. Nevertheless, healthcare prescribers have not wholly warmed to these newcomers, with dermatologists exhibiting the highest degree of stated resistance to change, and rheumatologists reporting the least actual erosion to branded Humira.
The vast majority of survey participants exhibit general awareness of the growing availability of multiple adalimumab biosimilars. Unsurprisingly, most readily recognize Amjevita as a prominent approved adalimumab biosimilar. Notably, regarding the cohort of adalimumab biosimilars launched in July 2023, awareness of Boehringer Ingelheim’s Cyltezo prevails across specialties, likely attributed to its unique position as the sole biosimilar granted interchangeability status by the FDA. Sandoz’s Hyrimoz and Biocon’s Hulio garner notable recognition among dermatologists and rheumatologists, while Coherus BioSciences’ Yusimry enjoys higher recall rates among gastroenterologists. Reported familiarity with these various assets follows a parallel pattern, with Amjevita’s familiarity outpacing all July-launched biosimilar brands and Cytelzo occupying a respectable second place, albeit at a considerable distance.
Despite the increasingly competitive landscape, specialists report that their overall use of adalimumab has remained relatively consistent over the course of 2023. That said, branded Humira share has consistently declined across all specialties, countered by overall growth in both the breadth and depth of Amjevita use. Of note, gastroenterologists and dermatologists report notable wave-over-wave increased adoption of Amjevita, while rheumatologists’ overall biosimilar adoption has been more tepid. Regardless of specialty, Cyltezo users are more prominent than any of the other recently launched adalimumab biosimilars. Despite this advantage, the overall estimated share of the Boehringer brand is comparable to the rest of the July additions and pales in comparison to Humira and Amjevita. Future projections reveal prescriber ambiguity and potential uncertainty regarding any of the recently launched biosimilars catching up to Amjevita. As one rheumatology biologic coordinator explains, “Amjevita had a good launch. I’d rather stick to Amjevita and what I know instead of trying a new biosimilar.”
Dermatologists remain the most resistant perceptually to adopting adalimumab biosimilars, with half maintaining that they are not likely to outright prescribe a biosimilar over branded Humira. One dermatology biologic coordinator specifies, “If Humira got a denial we would appeal it. The justification would be that biosimilars don’t have as much data. But I don’t know if that would fly.” Rheumatologists and gastroenterologists are more divided on their likelihood to prescribe a biosimilar outright over branded Humira, indicating less resistance to change.
Furthermore, while most specialists continue to write prescriptions specifically for Humira and await pushback from payers, dermatologists are increasingly likely to specify “dispense as written” (DAW) when prescribing Humira, and less likely to write for Humira and wait for payer pushback. Despite their intentions, gastroenterologists, and dermatologists increasingly report being asked to prescribe a biosimilar when writing Humira, and when this does happen, a growing majority report that they will then just go ahead and prescribe the biosimilar option, with those willing to argue for Humira dwindling. Rheumatologists report little change in payer pushback when prescribing Humira, as well as their response when payer pushback does occur.
One facet that could assist in further biosimilar adoption is clear and regular sales representative messaging given that most specialists report that they do not know how to differentiate between all the new adalimumab biosimilars on the market. Regarding sales representative contact, Humira continues to lead the pack with the most regular and frequent sales representative visits, regardless of specialty. Amjevita contact rates are highest among the biosimilars, though rheumatologists report much more frequent contact with an Amgen representative than their counterparts. Amjevita messaging regularly focuses on comparative efficacy and cost savings/coverage. Of the newer launched brands, Cyltezo again has the greatest presence out of the gate, with messaging nearly always including a focus on the brand’s interchangeability status; however, the majority have yet to meet with a Boehringer Ingelheim representative.
Going forward, efficacy is top of mind as prescribers’ leading concern when it comes to the adoption of the adalimumab biosimilars, followed by safety concerns, and an overall lack of cost savings. As one gastroenterologist offers, “[I have] concern that we are going through all this to ‘save money’ but are those cost savings being passed on to the patient or health care system at risk of the possibility of lack of efficacy or generation of immunogenicity for some patients.” Spherix will continue to monitor the evolving biosimilar landscape, including impacts on Humira and the overall biologic-treated population.
Special Topix™: Immune Biosimilars Today and Tomorrow (US) advisory service consists of quarterly deep dive reports based on a large-scale survey and select qualitative interviews with biologic coordinators. It is coupled with monthly pulses tracking HCP experience, perceptions, and intentions with Amgen’s Amjevita, Boehringer Ingelheim’s Cyltezo, Fresenius Kabi’s Idacio, Sandoz’s Hyrimoz and unbranded formulation, Celltrion’s Yuflyma, Biocon’s Hulio, Biocon/Viatris’ unbranded formulation, Coherus BioSciences’ Yusimry, Organon’s Hadlima, Pfizer’s Abrilada, and Teva’s AVT02.
About Spherix Global Insights
Spherix Global Insights is a leading provider of market research, business intelligence and advisory services to the global life sciences industry. The company’s unique service offerings are powered by deep therapeutic knowledge, the Spherix Network specialty physician panel, and commercially relevant analyses to enable strategic decision-making by our valued customers.
A trusted advisor and industry thought leader, Spherix Global Insights provides specialized market expertise in six (6) focused therapeutic areas including: dermatology, gastroenterology, nephrology, neurology, rheumatology, and ophthalmology.
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