Celltrion's anticancer biosimilar "Vegzelma" has been added one after another to the formularies of major U.S. pharmacy benefit managers (PBMs). As it enters the U.S. insurance reimbursement system, its sales channels are expected to expand.
Celltrion said on the 7th that Vegzelma has been listed as a preferred drug on the public and private insurance formularies of Express Scripts (ESI), one of the three largest PBMs in the United States, and on the public insurance formulary of Optum.
Reimbursement for ESI public insurance and Optum public insurance began on the 1st of this month, and ESI private insurance is scheduled to take effect from Jan. 1 next year.
PBMs are organizations that handle insurers' drug prescriptions and price negotiations, and they have a significant impact on U.S. drug distribution and prescribing. If a drug is not on a formulary, it is difficult to receive insurance reimbursement, which also limits actual prescription growth.
Celltrion said this listing has expanded Vegzelma's U.S. insurance reimbursement coverage to more than 35%. The company plans to continue negotiations to add the drug to the formularies of other large PBMs.
Vegzelma has so far expanded sales mainly in the market where medical institutions and pharmaceutical companies conduct direct transactions without insurance reimbursement. According to IQVIA, its U.S. market share in May was 10.6%, marking double digits for the first time since launch.