Investigating market trends and access implications for adalimumab following the loss of patent exclusivity: Lessons learned from biosimilar uptake in the U.S. biologic market

Biologics, including adalimumab, are some of the most expensive medications in the United States. This study set out to predict the changes in pricing and access to adalimumab after losing patent exclusivity by investigating market trends for other biosimilars that have lost exclusivity. Center for Medicare and Medicaid Services Medicare spending data from 2017 to 2021 was utilized to investigate market trends for several branded biologics and their biosimilars. Changes in cost per unit, total beneficiaries on the brand and change in total beneficiaries on brand or biosimilar were analyzed. Over this time frame with no competitor, branded adalimumab had a 72% cost per unit increase and 23% increase in total beneficiaries. Branded infliximab with competitors had a 53% cost reduction, 26% reduction of beneficiaries on the branded medication and a 1% decrease in beneficiaries on any form of infliximab, branded or biosimilar. Likewise, most other medications investigated showed a reduction in cost per unit and number of beneficiaries on the brand with a mixed trend in overall beneficiaries on any form of the medication. These trends indicate that biologics losing exclusivity, such as adalimumab, lead to a cost decrease with a loss in market share as expected. However, it is unknown if accessibility and affordability of these medications is changing as a corresponding increase in total beneficiaries on any form of the medication is not seen as might be expected with lower cost alternatives entering the market.