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Amgen biosimilar debut boosted by UnitedHealthcare coverage switch


Ned Pagliarulo@NedPagliarulo


Aug. 19 2019, 2:01 p.m. -04


Aug. 19, 2019

Dive Brief:

UnitedHealthcare, the nation's largest insurer, will preferentially coverlower-cost versions of Roche's top-selling cancer drugs Herceptin and Avastin beginning Oct. 1, giving a boost to biosimilar maker Amgen's efforts to steal away market share. Amgen launched the copycat drugs, sold respectively as Kanjinti and Mvasi, in July at prices 15% lower than what Roche charges for its products. The two drugs are the first cancer biosimilars to be made available in the U.S., although seven others have won Food and Drug Administration approval. Roche had sought to block Amgen from launching its biosimilars, but failed to win a court injunction that would have enabled it to prevent commercial sales while the companies await court rulings in cases on patents held by Roche. A federal appeals court last week denied Roche's second attempt at obtaining an injunction.

Dive Insight:

While Kanjinti (trastuzumab-anns) was the fifth Herceptin biosimilar approved in the U.S., Amgen capitalized quickly with a first-to-market launch. The four other biosimilar markers have reached settlement agreements with Roche to permit sales beginning in 2019 and 2020.

Amgen's aggressive strategy appears to be paying off, as favorable court decisions and the backing of a major insurer have strengthened Amgen's hand.

Starting in October, UnitedHealthcare will list Kanjinti as well as Mvasi (bevacizumab-awwb) as preferred for members covered under its commercial, community and Medicare Advantage plans. 

"UnitedHealthcare evaluates each brand name biologic and its biosimilar one-by-one and makes a coverage decision based on the lowest cost product in order to deliver lower costs to our members, clients and consumers," said the insurer in a statement to BioPharma Dive. 

As biosimilars need to be prescribed by physicians, such a change is likely to help both products gain traction. An early launch could also help position Amgen to hold a larger share of the market when others, such as Pfizer and Mylan, introduce their biosimilar copies.

In a statement, Amgen said it's seeing "favorable" marketplace responses to its biosimilar launches and noted it expects to secure "broad first-line coverage" as more payers decide on coverage. 

Herceptin, Avastin and Rituxan (rituximab), a third Roche cancer drug expected to soon see biosimilar competition, are some of the best-selling cancer drugs. Last year, Roche earned nearly $21 billion in worldwide sales of the three medicines, about $10 billion of which came from the U.S. market. 

Lower-cost biosimilars could be a compelling choice for insurers and oncology groups. 

"When we saw that these three agents were going to be eligible for potential therapeutic substitution, we made sure we learned as much as we could," said Jeffrey Patton, head of physician services at OneOncology, noting in an interview that the Roche drugs represented a third of the community oncology group's spending.

OneOncology, which is made up of four practices representing more than 250 cancer doctors, began purchasing Amgen's cancer biosimilars days after their launch, and currently recommends their use. 

"We hope to move as many patients as we can to the least-expensive alternative," Patton added.

UnitedHealthcare will also make preferred Novartis' biosimilar version of Amgen's Neupogen (filgrastim) beginning Oct. 1.

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