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Editor's Note
March 30, 2020

Decreasing Health Care Spending Through Market Competition–a Case for the Rapid Adoption of Adalimumab Biosimilars

Author Affiliations
  • 1Department of Internal Medicine, University of California at San Francisco, San Francisco
  • 2Editorial Fellow, JAMA Internal Medicine
  • 3Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
JAMA Intern Med. Published online March 30, 2020. doi:10.1001/jamainternmed.2020.0331

In the Research Letter, “Shift From Adalimumab Originator to Biosimilars in Denmark,” Jensen et al1 describe the marked savings Denmark experienced after a nationwide switch from the proprietary version of adalimumab (Humira) to the biosimilar. The extent of these savings and the rapidity of the switch, even absent a substitution mandate, mirrors similar successes with other biologic biosimilar campaigns in Denmark (and some European countries). In contrast, in the US, although the Food and Drug Administration has approved biosimilars for adalimumab, they will not enter the market until 2023 owing to patent disputes with AbbVie, the manufacturer of Humira. Jensen et al1 highlight the schemes other manufacturers have taken to dissuade biosimilars from formulary inclusion in the US, including use of rebate traps. In 2013, Humira had an annual postrebate price of $19 000, which had increased to $38 000 by 2018, meaning the delay in market entry of a biosimilar has a big effect not only on increasing spending for Humira, but also increasing spending on the biosimilar, which will be priced using Humira’s price as an anchor.

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