Vital Incite has been identifying an increase in 30-day cost for Humira. What we have learned is that 83% of persons on Humira have moved to a Citrate Free version of Humira. Citrate Free is marketed as giving less pain on injection but is not clinically different. The cost though is on average $400 more per month. For consideration, this Citrate Free version of the medication is not available in other countries. Further, with biosimilars expected to come to market next year, there are many opportunities to still provide access to a clinically equivalent medication without providing the most expensive option.