Spotlight: Biosimilars
NAVITUS | 2024 Drug Trend Report
Driving value through lower-cost clinically equivalent products
Targeted immunomodulators (TIMs) represented 40% of specialty spend in 2024, and Humira® (adalimumab) products accounted for 30% of category utilization. On June 1, 2024, Navitus added Humira biosimilars to commercial formularies.
As of July 1, 2025, Navitus will remove Stelara® from its formulary in favor of FDA-approved biosimilar alternatives. These are poised to reduce net claim costs by 85% compared to brand products and to deliver:
- Significant upfront net savings compared to brand product
- $120M forecast annual net cost savings for commercial clients
For Navitus clients that use Lumicera Health Services for specialty pharmacy, an exclusive purchase agreement for the Stelara biosimilar, ustekinumab-aekn, will deliver significant savings.
Close to home: A mother’s story
Amanda, Manager of Experiential Learning and Chair of the accredited Oncology Center of Excellence, has been a specialty pharmacist at Lumicera since 2023. For the past two years, she has also been a caregiver for a cancer patient…her son.
Learn more about their unique journey:
NAVITUS | 2024 Drug Trend Report
NAVITUS | 2024 Drug
Trend Report
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Methodology
The Navitus drug trend is calculated by comparing the net total cost PMPM for 2024 to that for 2023. Net cost PMPM represents full-year (Q1-Q4) data for total member copays and plan paid amounts, minus manufacturer rebates and fees. This value is divided by the total number of members and by 12 months of the year.
Net total cost PMPM trend consists of two components — utilization and cost — and includes both specialty and non-specialty drugs. Utilization trend measures the change in total days of therapy. Cost trend measures the change in net total drug cost per day of therapy. This analysis included data for more than 600 clients, representing 3.4M members within Navitus’ commercial book of business, including employer plan sponsors and health plans. To be included, these organizations must have been clients of Navitus in both 2023 and 2024. Exclusions from this analysis include products administered at physicians’ offices, clinics and hospitals, products subsidized by the federal government (i.e. COVID-19 vaccines/treatments), products excluded by benefit design (weight loss, infertility) and any additional savings from copay assistance programs.