Express Scripts to prefer first interchangeable biosimilar insulin
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Express Scripts will prefer Viatris’ insulin glargine-yfgn injection, the first FDA-approved interchangeable biosimilar insulin product, on its largest formulary, the company announced in a press release.
As Healio previously reported, insulin glargine-yfgn (Semglee) is both biosimilar to and interchangeable with its reference product insulin glargine (Lantus, Sanofi), a long-acting insulin analogue. Semglee was approved as a drug product under the 505(b)(2) new drug application pathway and is now deemed a biologic under section 351(a), in accordance with the Biologics Price Competition and Innovation Act. The FDA approved Semglee in July.
“We have advocated for more than a decade for a safe and effective pathway to bring biosimilars to market because they hold tremendous promise for cost savings for patients, plans and our entire health care system,” Amy Bricker, president of Express Scripts, said in the release. “The FDA approval of the first interchangeable biosimilar signals an historic opportunity to realize these cost-savings for our clients and members. This important designation is another milestone toward a pathway for the full adoption of biosimilars, which is critically important to making high-cost medications more affordable for patients, employers and health plans.”
Express Scripts estimates cost savings of $20 million in 2022 by preferring Semglee injection on its National Preferred Formulary (NPF), which includes more than 28 million people. Some members who use this medication will have reduced out-of-pocket costs, and the rest will maintain their current costs, according to the company.
Because the FDA approved Semglee injection as an interchangeable biosimilar, pharmacies can automatically substitute the product for the biologic, Lantus, at the point of dispensing, with no additional action needed from the provider or patient.
“For patients with diabetes, affordable access to insulin can be lifesaving,” Bricker said in the release. “We believe in the power of biosimilars to drive greater savings for diabetes medications without sacrificing clinical effectiveness or patient safety.”
In addition to preferring Semglee injection on the NPF and excluding the biologic, Lantus, Express Scripts will also add the product to its patient assurance program. In April 2019, Healio reported that the program would cap out-of-pocket insulin costs at $25 for a 30-day supply for eligible plan members with diabetes.
Semglee injection also will be added to the company’s SafeGuardRx Diabetes Care Value program, a program that offers high-touch support to people with diabetes to achieve greater health outcomes.
Perspective
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Campbell Hutton
Interchangeable biosimilar insulins are a step forward for the diabetes community as they broaden the treatment options available. They also hold potential for lowering out of pocket costs for people with diabetes, which is what JDRF is focused on. This announcement from Express-Scripts is certainly encouraging and will hopefully demonstrate that there is a viable pathway for interchangeable biosimilar insulins, and perhaps interchangeable biosimilars in general to be part of the solution.
It is difficult to predict the impact of this announcement on the person with diabetes, and that is something JDRF will watch closely. We are focused on ensuring patients, pharmacists and providers all have the education they need about interchangeable biosimilar insulins and also that choice, one of JDRF’s pillars, is protected. The choice of which diabetes therapy or device to use should always be between the patient and their health care provider.
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