With Humira Biosimilar Deal, Blue Shield of California Takes Aim at ‘Misaligned Incentives’

Blue Shield of California has been making moves to reduce drug costs for its members, including dropping the traditional PBM model and dividing the functions between five different vendors. Now, the insurer has struck a deal to offer a no-cost Humira biosimilar to its 4.8 million members. 

Evio Pharmacy Solutions — a startup owned by several Blues plans, including Blue Shield — negotiated with drug manufacturer Fresenius Kabi to purchase the biosimilar at $525 per monthly dose, compared to the $2,100 market-rate Humira dose. Beginning in January 2025, commercial plan members will be able to obtain the medication for $0. Humira is Blue Shield’s biggest drug expenditure, processing 40,000 prescriptions annually, according to the insurer.