CVS Health Expands Biosimilar Strategy, Dropping Amgen and Lilly Bone Disease Treatments from Formularies
核心洞察
CVS Health's Caremark (搜索) unit will replace Amgen's Prolia and Eli Lilly's Forteo with lower-cost biosimilar and generic alternatives on major commercial formularies starting April 1, 2026.
The formulary changes are expected to reduce prescription costs by more than 50% compared to branded drugs, building on CVS's successful biosimilar strategy that has generated $1.5 billion in gross savings.
This move follows CVS's previous decision to exclude AbbVie (搜索)'s Humira from formularies in favor of biosimilars, with 96% of Caremark (搜索) members successfully transitioning to cheaper alternatives.
CVS Health announced Thursday it will remove Amgen's Prolia and Eli Lilly's Forteo from some of its preferred drug lists, replacing them with lower-cost biosimilar and generic alternatives as part of an expanded strategy to reduce prescription drug costs for patients.
The pharmacy benefit management unit Caremark (搜索) will add biosimilar versions of Amgen's osteoporosis (搜索) treatment Prolia, including Ospomyv (搜索) sold by CVS unit Cordavis (搜索) and Celltrion's Stoboclo, to major national commercial formularies beginning April 1, 2026. The company will also include generic versions of Lilly's Forteo, such as Bonsity and Tymlos.
Significant Cost Savings Expected
The formulary changes are projected to lower costs by more than 50% per prescription compared with the branded drugs, according to CVS. The company's biosimilar formulary strategy has already generated $1.5 billion in gross savings for customers and their members to date.
"We were the first pharmacy benefit manager to remove Humira from its commercial template formulary in favor of less expensive biosimilars," said Ed DeVaney, President of CVS Caremark (搜索). The strategy has demonstrated the value of using formulary tools to drive competition in the pharmaceutical market.
Building on Previous Success
The move builds on Caremark (搜索)'s 2024 decision to exclude AbbVie (搜索)'s blockbuster arthritis (搜索) drug Humira from its lists in favor of cheaper biosimilars. CVS reported that approximately 96% of Caremark members using Humira have successfully switched to a biosimilar alternative.
Key U.S. patents for Prolia, used to treat osteoporosis (搜索) and other bone conditions (搜索), expired in 2025, while primary patents for Forteo expired in 2019. Amgen reported global Prolia sales of approximately $4.4 billion in 2025, highlighting the significant market impact of these formulary changes.
Market Dynamics and Patient Transition
Unlike conventional generic drugs, which are exact copies of branded medicines, biosimilars are complex biotech drugs made from living cells that cannot be exactly matched but offer no clinically meaningful differences from their reference products.
Prolia and its biosimilar alternatives are specialty drugs dispensed by CVS Specialty. When formulary changes occur, CVS Specialty contacts both prescribers and patients to explain the update and guide them through the transition process.
Industry Context
Pharmacy benefit managers act as middlemen for employers and health plans, negotiating rebates and fees with manufacturers while creating formularies of medications covered by insurance. Three major PBMs—CVS's Caremark (搜索), Cigna's Express Scripts, and UnitedHealth Group's Optum Rx—control 80% of the U.S. prescription drug market.
The expanded biosimilar strategy represents CVS's continued effort to leverage formulary management as a tool to drive pharmaceutical market competition and reduce healthcare costs for patients and payers.