What are PBM private-label biosimilars and why are they controversial?
All three large PBMs shifted 2025 national formularies to their own brands — Caremark/Cordavis, Express Scripts/Quallent, Optum/Nuvaila — excluding nearly all independent biosimilars and raising conflict-of-interest concerns that could deter future biosimilar investment.
For 2025, all three of the largest PBMs shifted national formularies to favour their own private-label biosimilars: Caremark with Cordavis, Express Scripts with Quallent and Optum with Nuvaila. Nearly all other marketed Humira biosimilars were excluded from the largest PBMs' 2025 formularies. Drug Channels argued that PBMs' benefits from private labels can align with those of plan sponsors and patients, since private labels generally carry low net costs. Critics counter that when a PBM owns or co-brands a product, it faces a conflict of interest, and independent biosimilar makers are shut out, which could deter future investment in biosimilars. One analysis warned plan sponsors to watch for pushback and regulatory scrutiny of the private-label models. There are now eight distinct adalimumab brands causing confusion at pharmacies.