Simlandi is the only biosimilar to Humira on the market that is high-concentration, citrate-free, and interchangeable.
The FDA has approved Simlandi (adalimumab-ryvk), which joins Pfizer’s Abrilada (adalimumab-afzb) and Boehringer Ingelheim’s Cyltezo (adalimumab-adbm) as interchangeable with AbbVie’s Humira’s (adalimumab), the reference brand-name product that has set all kinds of sales records, for some uses.1
'Biosimilar' spelled in wooden tiles / lexiconimages - stock.adobe.com
Interchangeability means the biosimilar can be substituted for the reference product or another biosimilar at the pharmacy level, although state-level pharmacy regulations can complicate matters. Interchangeability is widely seen as important for gaining market share in the increasingly crowded market for Humira biosimilars and for pharmacy benefit managers (PBMs) steering prescriptions to their preferred products.
A total of 9 Humira biosimilars are on the market in the US, so Alvotech's Simlandi will be the 10th.
Biosimilars are replicas of brand-name biologics that are supposed to help bring down health care cost by creating price competition. The market for biosimilars has been slow to develop in the US for a number of reasons, including PBMs having a business interest in keeping higher priced brand-name products on their lists of covered drugs (formularies).
Biosimilar trade groups say, though, that more biosimilars are being prescribed. One group said biosimilars collectively led to $9.4 billion in savings in 2022, a year before the Humira biosimilars starting to come on the market. AbbVie has reported sharp decreases in Humira as result of biosimilar competition.
First approved in late 2002 as a treatment for rheumatoid arthritis, Humira has piled up additional approvals for other autoimmune conditions. The drug, which inhibits tumor necrosis factor, has powerful anti-inflammatory effects.
READ MORE: Adalimumab-atto Biosimilar Well Received After Launch
Alvotech, which is headquartered and has manufacturing facilities in Iceland, is a late comer to the US Humira biosimilar market because the FDA identified problems with its manufacturing processes, which led to 2 complete response letters—an official FDA notification that tells a manufacturer that their application will not be approved in its current form. Although not a rejection, complete response letters delay approvals and sometimes lead to drugmakers abandoning a product that has been in development.
Alvotech and Teva Pharmaceuticals announced the FDA approval in a news release issued last week. Teva, a major generic medication manufacturer and marketer, will commercialize and market Simlandi in the US. European drug regulators approved the biosimilar in 2021 and it is marketed in Europe under a different name, Hukyndra.
The news release touts Simlandi as the first high-concentration, citrate-free biosimilar to Humira that is interchangeable. Citrate is a buffer that stabilizes medications, but it causes burning and pain at the injection. Other buffers have been identified, and all of the 9 Humira biosimilars on the US market are citrate-free formulations. However, Simlandi is also a high-concentration version of adalimumab. Most of Humira prescriptions are for high-concentration formulations. The other 2 Humira biosimilars with the interchangeable designation, Abrilada and Cyltezo, are low-concentration formulations, so at the moment, Simlandi has the high-concentration, citrate-free and interchangeable Humira biosimilar market to itself.
READ MORE: Biosimilars Resource Center
This article originally appeared in Managed Healthcare Executive.
