CVS Health expands biosimilar coverage to lower osteoporosis treatment costs

WOONSOCKET, R.I. — CVS Health announced it will expand access to more affordable osteoporosis therapies through formulary adjustments aimed at speeding up biosimilar adoption and lowering pharmacy costs for employers and members.

Effective April 1, CVS Caremark will add osteoporosis biosimilars Ospomyv and Stoboclo, along with generic teriparatide options Bonsity and Tymlos, to major national commercial template formularies. These products will replace reference brands Prolia and Forteo. CVS Caremark stated that this move results in more than 50% lower costs per prescription compared to the original branded therapies.

CVS Caremark stated that the change expands its broader biosimilar strategy, including its earlier decision to exclude reference brand Humira from commercial template formularies in favor of lower-priced biosimilars. The company says this approach has resulted in $1.5 billion in gross savings for customers and members, with 96% of Caremark clients successfully transitioning from Humira to a biosimilar.

“Caremark was the first pharmacy benefit manager to exclude reference brand Humira from our commercial template formulary in favor of biosimilars priced dramatically less than the branded product,” said Ed DeVaney, president of CVS Caremark. “The results illustrate the value we can deliver when we use our tools to drive competition.”

Since Prolia is a specialty medication, the formulary change will be supported by outreach from CVS Specialty. The specialty pharmacy will proactively notify prescribers and patients about the change, guide providers in submitting new prescriptions for covered alternatives, and communicate with patients through digital or phone channels based on individual preferences.

“When a CVS Specialty patient’s plan formulary changes, our advanced technology allows us to streamline the process for the doctor and reduce friction for the patient,” said Lucille Accetta, RPh, MPH, MBA, senior vice president and head of CVS Specialty Operations at CVS Health.

The newly launched Prolia biosimilars include Ospomyv, marketed by Cordavis Limited, and Stoboclo, produced by Celltrion. Both are FDA-approved to treat osteoporosis in high-risk patients and to increase bone density in certain men and women undergoing cancer treatments.

CVS Health stated that expanding access to these therapies is essential because osteoporosis-related fractures can cause serious complications, including loss of independence and higher mortality rates among older adults. By focusing on biosimilars with dependable supply and comparable clinical results, the company aims to enhance access to effective osteoporosis treatment while reducing overall costs.