The Impact of Infliximab-abda (Renflexis) on Insurers and Organizations

August 01, 2017
Infliximab-abda (Renflexis), biosimilar to Janssen Biotech tumor necrosis factor inhibitor infliximab (Remicade), is being introduced into the US market at a list price of $753.39, which represents a 35% discount off the current list price of Remicade. Merck and Samsung Bioepis have made a bold move by introducing the second biosimilar to Remicade at a significant discount. 

Remicade and its 2 biosimilars, infliximab-abda and infliximab-dyyb (Inflectra) are long term treatments that are, for the most part, administered under the medical benefit. 

Celltrion’s and Pfizer’s Inflectra has struggled to capture market share from Remicade due to factors such as offering a low discount (15%) off the originator’s list price and not being able to overcome effective contracting strategies and additional discounts provided by Janssen. Remicade erosion was targeted to be somewhere between 10%-15% and the erosion has been only about 5% in Q2 2017, which is less severe than expected.

In order to successfully capture more of Remicade’s US market share and $4.84 B in annual sales, Merck and Samsung Bioepsis have offered a 35% discount off the list price of Remicade. This discount, which is more than double Inflectra’s discount, will influence commercial insurers to evaluate the opportunity and then perhaps implement medical benefit (as well as pharmacy benefit) formulary changes to prefer Renflexis over Remicade. Additionally, this discount may encourage organizations that administer these drugs (ie, health systems) to begin utilizing and stocking up on Renflexis. Under the current Medicare Part B coding and reimbursement policy for biosimilars, providers will likely profit from a good portion of the 20% price difference between Renflexis and Inflectra, which share the same billing code.

The introduction of a second biosimilar, and future biosimilars, to Remicade along with a favorable management by insurers and utilization by organizations administering these drugs will help advance price competition, increase market share for biosimilars, and improve access for patients in the United States. We will see over the course of 2017 and 2018 whether the discount offered by Merck and Samsung was enough to influence insurers to prefer the biosimilar over the innovator.  

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