BLOOMFIELD, Conn., October 20, 2021 – Express Scripts, an Evernorth company, announced today that as part of its commitment to drive greater affordability for plans and people living with diabetes, it will prefer Viatris’ Semglee®(insulin glargine-yfgn) injection, the first Food and Drug Administration (FDA)–approved interchangeable biosimilar insulin product, on its largest formulary.
“We have advocated for more than a decade for a safe and effective pathway to bring biosimilars to market because they hold tremendous promise for cost savings for patients, plans and our entire health care system,” said Amy Bricker, president, Express Scripts. “The FDA approval of the first interchangeable biosimilar signals an historic opportunity to realize these cost-savings for our clients and members. This important designation is another milestone toward a pathway for the full adoption of biosimilars, which is critically important to making high-cost medications more affordable for patients, employers and health plans.”
Express Scripts estimates cost savings of $20 million in 2022 by preferring Semglee injection on its National Preferred Formulary® (NPF), which includes more than 28 million lives. Some members who use this medication will have reduced out-of-pocket costs, and the rest will maintain their current costs.
Biosimilars, the clinically equivalent alternatives to high-priced biologic medicines, hold considerable savings potential through direct cost savings and competition that encourages lower prices. An Evernorth analysis estimates biosimilars could reduce drug spending by $225 billion to $375 billion over the next decade.
To earn interchangeable status, Semglee injection met rigorous clinical and regulatory standards, producing the same clinical result as the original biologic. Like generic equivalents for non-biologic medications, because the FDA approved Semglee injection as an interchangeable biosimilar, pharmacies can automatically substitute the product for the biologic, Lantus, at the point of dispensing, with no additional action needed from the provider or patient.
“For patients with diabetes, affordable access to insulin can be lifesaving,” said Bricker. “We believe in the power of biosimilars to drive greater savings for diabetes medications without sacrificing clinical effectiveness or patient safety.”
In addition to preferring Semglee injection on the NPF and excluding the biologic, Lantus®, Express Scripts will add the product to its industry-leading Patient Assurance Program, which protects patients from high out-of-pocket costs by capping member copays at $25 for up to a 34-day supply of select diabetes medications. Beginning January 1, 2022, the program will expand to include select cardiovascular medications that have been proven to reduce the risk of stroke.
Semglee injection also will be added to the company’s SafeGuardRx® Diabetes Care Value program, an industry leading value-based care solution that provides high-touch support to people with diabetes to achieve greater health outcomes.
Evernorth creates and connects premier health services offerings, including benefits management, pharmacy, care solutions, insights, and intelligence. With an open approach to partnering across the health care landscape, we deliver innovative and flexible solutions for health plans, employers and government programs. Evernorth capabilities are powered by our family of companies, including Express Scripts, Accredo, eviCore and MDLIVE, along with holistic Evernorth platforms and solutions that elevate health and drive progress for people and businesses. All Evernorth solutions are serviced and provided by or through operating affiliates of Evernorth Health, a wholly owned subsidiary of Cigna Corporation, or third-party partners. Learn more at Evernorth.com.