CVS Health announced that its pharmacy‑benefit‑manager arm, CVS Caremark, will drop Amgen’s bone‑disease drugs Prolia and Xgeva from its preferred drug lists effective April 1, 2026. The change follows the approval of interchangeable biosimilars for both products and a company‑wide push to lower drug costs for payers and patients.
Prolia and Xgeva together generated $6.6 billion in revenue for Amgen in 2024, with Prolia accounting for $4.37 billion and Xgeva for $2.23 billion. In the fourth quarter of 2025, Prolia sales grew 12% year‑over‑year to $1.1 billion, while Xgeva sales increased 6% to $1.3 billion. The removal of these brands from CVS’s formulary is expected to reduce Amgen’s reimbursement rates and erode its share of the osteoporosis and bone‑metastasis markets, potentially translating into a multi‑hundred‑million‑dollar revenue hit.
CVS’s rationale centers on the availability of lower‑cost biosimilars. The company will replace Prolia and Xgeva with the biosimilars Jubbonti and Wyost from Sandoz, as well as Celltrion’s Stoboclo and Osenvelt, and generic teriparatide products Bonsity and Tymlos. CVS estimates these alternatives are more than 50% cheaper per prescription, a savings that aligns with its broader strategy to drive down drug spending for its members and commercial clients.
Amgen’s management has acknowledged the competitive pressure. In its Q4 2025 earnings call, CFO Peter Griffith noted that the company expects 2026 revenue to be “more than offset by anticipated declines from increased denosumab biosimilar competition.” Amgen’s 2026 revenue guidance of $37.0 billion to $38.4 billion reflects confidence that growth in other therapeutic areas—such as cardiovascular and oncology—will compensate for the erosion in its bone‑health franchise.
The formulary shift underscores the accelerating biosimilar market. FDA approval of interchangeable biosimilars for Prolia and Xgeva in March 2024 opened the door for multiple competitors, and CVS’s decision signals a broader industry trend toward cost containment. Ed DeVaney, president of CVS Caremark, said the move “illustrates the value we can deliver when we leverage our tools to drive competition.” The change is likely to prompt other PBMs to follow suit, intensifying pressure on Amgen and its competitors.
Amgen’s strategic response will focus on maintaining pricing power in its high‑margin segments while investing in new product development. The company’s guidance indicates that, despite the expected decline in bone‑health revenue, it remains confident in its overall growth trajectory and its ability to navigate the evolving biosimilar landscape.
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